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Abstract #0684

Evidence of arteriovenous shunting in arterial spin labeling MRI in adults with sickle cell anemia

Meher R Juttukonda1, Manus J Donahue1, Melissa C Gindville2, Jeroen Hendrikse3, and Lori C Jordan2

1Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States, 2Pediatrics - Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, United States, 3Radiology, University Medical Center Utrecht, Utrecht, Netherlands

High cervical arterial flow velocity may cause rapid erythrocyte transit through cerebral capillaries resulting in arteriovenous shunting, which may present as hyperintensities in pseudo-continuous arterial spin labeling (pCASL) MR difference images in draining veins. In an analysis of 36 adults with sickle cell anemia (SCA) and 11 age-matched controls, hyperintense superior sagittal sinus pCASL signal was present in 9% of controls and 61% of patients and correlated with elevated flow velocities. This shunting effect also trended with other markers of hemo-metabolic impairment in patients, such as elevated oxygen extraction fraction, elevated cerebral blood flow, and decreased blood hematocrit.

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