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Diagnostic ultrasound ( PDFDrive )

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1600 PART V Pediatric Sonography

Left MCA

A

B

C

D

FIG. 47.6 Middle Cerebral Artery (MCA) Stenosis in 9-Year-Old With Sickle Cell Disease. (A) TCD sonogram demonstrates extremely

elevated velocities in the left MCA, including a PSV of 359 cm/sec and time-averaged peak velocity of 285 cm/sec. (B) MRA 3D time-of-light image

of the circle of Willis demonstrates diffuse narrowing of the left MCA, with multiple small vessels suggestive of moyamoya angiopathy. (C)

Reformatted maximum-intensity projection image of the same patient conirms narrowing of the left MCA (arrow). (D) Axial fast spin-echo

T2-weighted MR image demonstrates volume loss of the left basal ganglia and left hemispheric white matter, with signal voids secondary to

multiple collaterals.

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