Diffuse dural sinus hyperintensities on arterial spin labeling reflects reduced cerebral metabolic rate of oxygen in sickle cell anemia patients

Sickle cell anemia (SCA) patients have elevated cerebral blood flow and flow velocities to partially compensate for reduced blood oxygen content; this phenomenon may result in inefficient oxygen delivery to tissue due to accelerated red cell capillary transit. Pseudo-continuous arterial spin labeling (pCASL) and T2-relaxation-under-sping-tagging (TRUST) MRI methods were used to assess arterial-to-venous transit artifacts and oxygen metabolism in 150 SCA participants. Patients with diffuse dural sinus hyperintensities on pCASL had 22.7% lower cerebral metabolic rates of oxygen compared to their counterparts; however, values remained within a normal range of 2.91±0.69 ml O2/100g/min and were not associated with infarct history.