TCD for Sickle Cell

SUBJECT:  Transcranial Doppler in Children with Sickle Cell Disease
SECTION:  Vascular Ultrasound      
ORIGINATOR:  Deborah L. Richert, BSVT, RDMS, RVT
DATE:  September 27, 2013 

APPROVED BY:       ___________________________
                                    Jody Riherd MD
                                    ___________________________
                                    Dave Clayton RDMS RVT

 

 

Purpose:  Transcranial Doppler imaging is being used in the evaluation of children with sickle cell disease as a method to identify those children at risk for stroke. 

 

Exam Protocol:  Bilaterally the following vessels in the Circle of Willis are evaluated with color and spectral Doppler (do NOT angle correct) and the highest TAMAX is recorded for each vessel:  Terminal ICA, MCA/ACA bifurcation, MCA, and ACA.

Imaging Protocol:  (Do NOT angle correct)

RT terminal ICA with color and spectral Doppler with TAMAX measured
RT MCA/ACA bifurcation with color and spectral Doppler with TAMAX measured – evaluate each vessel proximally at the level they bifurcate from the terminal ICA
RT MCA with color and spectral Doppler with TAMAX measured
RT ACA with color and spectral Doppler with TAMAX measured
LT terminal ICA with color and spectral Doppler with TAMAX measured
LT MCA/ACA bifurcation with color and spectral Doppler with TAMAX measured – evaluate each vessel proximally at the level they bifurcate from the terminal ICA
LT MCA with color and spectral Doppler with TAMAX measured
LT ACA with color and spectral Doppler with TAMAX measured

 

STOP Criteria
TAMAX:  < 170 cm/s: Normal
TAMAX:  170 - 199 cm/s: Conditional
TAMAX:  > 200 cm/s: At risk

Reference

Malouf, Abe J. Jr., Hamrick-Turner, Jennifer E., et al:  Implementation of the STOP Protocol for Stroke Prevention in Sickle Cell Anemia by Using Duplex Power Doppler Imaging; Pediatric Imaging, volume 219, number 2, 359-365.
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