Non-invasive imaging of oxygen extraction fraction in adults with sickle cell anaemia

Lori C. Jordan, Melissa C. Gindville, Allison O. Scott, Meher R. Juttukonda, Megan K. Strother, Adetola A. Kassim, Sheau Chiann Chen, Hanzhang Lu, Sumit Pruthi, Yu Shyr, Manus J. Donahue

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Sickle cell anaemia is a monogenetic disorder with a high incidence of stroke. While stroke screening procedures exist for children with sickle cell anaemia, no accepted screening procedures exist for assessing stroke risk in adults. The purpose of this study is to use novel magnetic resonance imaging methods to evaluate physiological relationships between oxygen extraction fraction, cerebral blood flow, and clinical markers of cerebrovascular impairment in adults with sickle cell anaemia. The specific goal is to determine to what extent elevated oxygen extraction fraction may be uniquely present in patients with higher levels of clinical impairment and therefore may represent a candidate biomarker of stroke risk. Neurological evaluation, structural imaging, and the noninvasive T2-relaxation-under-spin-tagging magnetic resonance imaging method were applied in sickle cell anaemia (n = 34) and healthy race-matched control (n = 11) volunteers without sickle cell trait to assess whole-brain oxygen extraction fraction, cerebral blood flow, degree of vasculopathy, severity of anaemia, and presence of prior infarct; findings were interpreted in the context of physiological models. Cerebral blood flow and oxygen extraction fraction were elevated (P <0.05) in participants with sickle cell anaemia (n = 27) not receiving monthly blood transfusions (interquartile range cerebral blood flow = 46.2-56.8 ml/100 g/min; oxygen extraction fraction = 0.39-0.50) relative to controls (interquartile range cerebral blood flow = 40.8-46.3 ml/100 g/min; oxygen extraction fraction = 0.33-0.38). Oxygen extraction fraction (P <0.0001) but not cerebral blood flow was increased in participants with higher levels of clinical impairment. These data provide support for T2-relaxation-under-spin-tagging being able to quickly and non-invasively detect elevated oxygen extraction fraction in individuals with sickle cell anaemia with higher levels of clinical impairment. Our results support the premise that magnetic resonance imaging-based assessment of elevated oxygen extraction fraction might be a viable screening tool for evaluating stroke risk in adults with sickle cell anaemia.

Original languageEnglish (US)
Pages (from-to)738-750
Number of pages13
JournalBrain
Volume139
Issue number3
DOIs
StatePublished - Mar 1 2016

Fingerprint

Cerebrovascular Circulation
Sickle Cell Anemia
Oxygen
Stroke
Magnetic Resonance Imaging
Biomarkers
Sickle Cell Trait
Blood Transfusion
Anemia
Volunteers
Incidence
Brain

Keywords

  • Arterial spin labelling
  • Brain ischaemia
  • Cerebral haemodynamics
  • Oxygen extraction fraction
  • Sickle cell anaemia

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Jordan, L. C., Gindville, M. C., Scott, A. O., Juttukonda, M. R., Strother, M. K., Kassim, A. A., ... Donahue, M. J. (2016). Non-invasive imaging of oxygen extraction fraction in adults with sickle cell anaemia. Brain, 139(3), 738-750. https://doi.org/10.1093/brain/awv397

Non-invasive imaging of oxygen extraction fraction in adults with sickle cell anaemia. / Jordan, Lori C.; Gindville, Melissa C.; Scott, Allison O.; Juttukonda, Meher R.; Strother, Megan K.; Kassim, Adetola A.; Chen, Sheau Chiann; Lu, Hanzhang; Pruthi, Sumit; Shyr, Yu; Donahue, Manus J.

In: Brain, Vol. 139, No. 3, 01.03.2016, p. 738-750.

Research output: Contribution to journalArticle

Jordan, LC, Gindville, MC, Scott, AO, Juttukonda, MR, Strother, MK, Kassim, AA, Chen, SC, Lu, H, Pruthi, S, Shyr, Y & Donahue, MJ 2016, 'Non-invasive imaging of oxygen extraction fraction in adults with sickle cell anaemia', Brain, vol. 139, no. 3, pp. 738-750. https://doi.org/10.1093/brain/awv397
Jordan LC, Gindville MC, Scott AO, Juttukonda MR, Strother MK, Kassim AA et al. Non-invasive imaging of oxygen extraction fraction in adults with sickle cell anaemia. Brain. 2016 Mar 1;139(3):738-750. https://doi.org/10.1093/brain/awv397
Jordan, Lori C. ; Gindville, Melissa C. ; Scott, Allison O. ; Juttukonda, Meher R. ; Strother, Megan K. ; Kassim, Adetola A. ; Chen, Sheau Chiann ; Lu, Hanzhang ; Pruthi, Sumit ; Shyr, Yu ; Donahue, Manus J. / Non-invasive imaging of oxygen extraction fraction in adults with sickle cell anaemia. In: Brain. 2016 ; Vol. 139, No. 3. pp. 738-750.
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