ArticleJournal of magnetic resonance imaging : JMRI2026
Cerebral Blood Transit in Sickle Cell Anemia.
Article in Journal of magnetic resonance imaging : JMRI, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSickle cell anemia (SCA) patients upregulate cerebral blood flow to compensate for decreased arterial oxygen content. Such hyperemic conditions can manifest as venous hyperintense signal on arterial spin labeling (ASL) MRI, which may reflect faster capillary blood transit, altered oxygen extraction fraction (OEF), and infarct risk. PURPOSE: To implement multi-delay ASL to quantify cerebral arterial arrival time (AAT), arterial transit time (ATT) to tissue, and venous arrival time (VAT) and to test whether reductions in these parameters are present in SCA and relate to condition severity. STUDY TYPE: Prospective, cross-sectional. SUBJECTS: Adults with SCA (n = 40; age = 28.1 ± 7.1 years; sex = 47.5% female) and nonanemic controls (n = 24; age = 30.6 ± 6.6 years; sex = 37.5% male). FIELD STRENGTH/SEQUENCE: 3 T 3D T ASSESSMENT: Multi-delay PASL was used to quantify AAT, gray matter ATT, VAT, and labeled venous blood volume. Venous hyperintensities and OEF were quantified from 3D pCASL and TRUST, respectively. Infarcts and vasculopathy were assessed from radiological review. STATISTICAL TESTS: AAT, gray matter ATT, VAT, and labeled venous blood volume were evaluated using a Wilcoxon rank-sum test; ANOVA assessed relationships with venous hyperintense signal. Continuous variable relationships were assessed using Spearman rank-correlation (significance: two-sided p < 0.05).
resultsVenous labeled blood volume was significantly increased in SCA (median = 0.015 mL; IQR = 0.0087-0.023 mL) versus control (median = 0.0047 mL; IQR = 0.0032-0.0092 mL) participants, whereas VAT was significantly reduced in SCA (median = 2.53 s; IQR = 2.23-2.72 s) versus control (median = 2.75 s; IQR = 2.63-2.80 s) participants. AAT, gray matter ATT, and VAT values were not significantly related to OEF (AAT: p = 0.38; gray matter ATT: p = 0.24; VAT: p = 0.48) or prior infarct (AAT: p = 0.99; gray matter ATT: p = 0.88; VAT: p = 0.98). AAT and gray matter ATT, but not VAT (p = 0.153), were directly related to hemoglobin.
conclusionSCA patients had elevated labeled venous blood volume and shorter VAT. Differential relationships between blood transit and hemoglobin across vascular compartments provides support for venous blood kinetics not representing a simple sequela of anemia severity. EVIDENCE LEVEL: 2. TECHNICAL STAGE OF DEVELOPMENT: 2.
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