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Subject Area

Radiology and Imaging Sciences

Article Type

Original Study

Abstract

Objective To assess the role of transcranial ultrasound in children with sickle-cell disease to predict stroke and prevent its occurrence. Background Transcranial Doppler (TCD) ultrasound is a noninvasive and inexpensive imaging modality to measure mean blood-flow velocities through large intracerebral arteries in children with sickle-cell disease. Patients and methods The study was conducted on 20 patients presenting sickle-cell disease diagnosed by clinical examination and laboratory investigations. Patients included in this study were subjected to detailed history with special emphasis on the history of present illness suggestive of sickle-cell disease, clinical examination, and TCD ultrasonography for all patients. Results The best cutoff of the anterior cerebral artery in TCD in the prediction of transient ischemic attack (TIA) among the studied patients is more than or equal to 127.5, with the area under the curve (AUC) 0.933, sensitivity 80%, specificity 80%, positive predictive value (PPV) 57.1%, negative predictive value (NPV) 92.3%, and accuracy 80%, the best cutoff of the middle cerebral artery in the prediction of TIA among the studied patients is more than or equal to 155.5, with AUC 0.926, sensitivity 80%, specificity 66.7%, PPV 44.4%, NPV 90.9%, and accuracy 70%, and the best cutoff of posterior cerebral arteries (in the prediction of TIA among the studied patients is ≥105, with AUC 0.68, sensitivity 80%, specificity 53.3%, PPV 36.4%, NPV 88.9%, and accuracy 60%). Conclusion The use of TCD is a useful screening test for sickle-cell disease in children.

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