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Comparing segmented ASL perfusion of vascular territories using manual versus semiautomated techniques in children with sickle cell anemia
Author(s) -
Helton Kathleen J.,
Glass John O.,
Reddick Wilburn E.,
Paydar Amir,
Zandieh Arash R.,
Dave Rachna,
Smeltzer Matthew P.,
Wu Song,
Hankins Jane,
Aygun Banu,
Ogg Robert J.
Publication year - 2015
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24855
Subject(s) - medicine , perfusion , cerebral blood flow , sickle cell anemia , white matter , anemia , hemoglobin , limits of agreement , nuclear medicine , hemoglobin f , cardiology , magnetic resonance imaging , radiology , fetal hemoglobin , biology , pregnancy , fetus , genetics , disease
Purpose Elevated cerebral blood flow (CBF) in sickle cell anemia (SCA) is an adaptive pathophysiologic response associated with decreased vascular reserve and increased risk for ischemia. We compared manual (M) and semiautomated (SA) vascular territory delineation to facilitate standardized evaluation of CBF in children with SCA. Materials and Methods ASL perfusion values from 21 children were compared for gray matter and white matter (WM) in vascular territories defined by M and SA delineation. SA delineated CBF was compared with clinical and hematologic variables acquired within 4 weeks of the MRI. Results CBF measurements from M (MCA 82 left, 79 right) and SA (MCA 81 left, 81 right) delineated territories were highly correlated (R = 0.99, P < 0.0001). Bland‐Altman plots had close‐fitting limits of agreement of −1.8 to −3.5 lower limit and 0 to 1.8 upper limit. SA vascular territory delineation was comparable to the expert delineation with a kappa index of 0.62–0.85 and was considerably faster. Median territorial CBF values did not differ by gender or age. WM perfusion in the posterior cerebral artery territories was positively correlated with degree of hemolysis (R = 0.58, P = 0.01 left, 0.73, P < 0.001 right) and negatively correlated with hemoglobin (R = −0.48; P = 0.03 left; −0.47; P = 0.04 right) and hemoglobin F (R = −0.42; P = .09 left; −0.47; P = 0.049 right). Conclusion We established the validity of the SA method, which in our experience was much faster than the M method for delineation of vascular territories. Associations between CBF and hematologic variables may demonstrate pathophysiologic changes that contribute to clinical variation in CBF. J. Magn. Reson. Imaging 2015;41:439–446. © 2013 Wiley Periodicals, Inc .