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Diagnostic ultrasound ( PDFDrive )

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CHAPTER 47 Doppler Sonography of the Brain in Children 1601

A

B

C

D

E

FIG. 47.7 Developing Stroke in Asymptomatic 13-Year-Old Boy With Sickle Cell Anemia. (A) TCD sonogram through the left eye shows

relatively normal ophthalmic waveform with normal RI of 0.78 but increased low with a maximum velocity of 43 cm/sec. (B) TCD sonogram

through the right eye shows more abnormal waveform with increased diastolic low in the right ophthalmic artery (OA) with a low RI of 0.43. (C)

Axial 3D time-of-light MR angiogram shows absent ACAs bilaterally with prominent right OA (arrow). (D) Vertebral arteriogram demonstrates

retrograde illing of the ACA. (E) Initial image (on left) obtained at time of MRA is normal. Six months later, patient had acute stroke, and second

MR angiogram now shows bilateral, spotty, hyperintense areas in the ACA distribution. Both images are axial proton density weighted.

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