Objective: To investigate the changes in brain injury after the induction chemotherapy in children with acute lymphoblastic leukemia (ALL) by cranial MRI.
Methods: The clinical data and cranial MRI results of 62 children with ALL who were hospitalized from March 2014 to June 2015 were analyzed retrospectively.
Results: Before chemotherapy, MRI showed bone marrow infiltration of the skull in 33 patients (53%); the children with WBC<20×10(9)/Lhad a significantly lower incidence rate of bone marrow infiltration of the skull than those with WBC≥20×10(9)/L (16 patients/42% vs 17 patients/71%; P<0.05), and the high-risk group had a significantly higher incidence rate of bone marrow infiltration of the skull than the non-high-risk group (71% vs 44%; P<0.05). Before chemotherapy, there were 4 cases (7%) of brain atrophy, and 2 cases (3%) of abnormal signals in the sensory conduction bundle. MRI reexamination in 28 patients after 3 months of chemotherapy showed 3 new cases (11%) of brain atrophy and 1 aggravated case of brain atrophy.
Conclusions: The children with ALL have bone marrow infiltration of the skull, brain atrophy, and abnormal signals in the sensory conduction bundle before chemotherapy, especially bone marrow infiltration of the skull, and some changes in brain injury disappear after treatment.
目的: 用头颅磁共振(MRI)探讨儿童急性淋巴细胞白血病(ALL)诱导化疗前后颅脑损伤的变化。
方法: 对2014年3月至2015年6月期间62例ALL患儿化疗前后的临床资料及头颅MRI结果进行回顾性研究。
结果: 化疗前头颅MRI提示, 33例(53%)颅骨骨髓浸润, 其中WBC＜20×109/L者(16例, 42%)明显少于WBC ≥ 20×109/L者(17例, 71%), P＜0.05;高危组颅骨骨髓浸润发生率(71%)明显高于非高危组(44%), P＜0.05。脑萎缩4例(7%), 感觉传导束异常信号2例(3%)。28例患儿化疗3月后复查, 新出现脑萎缩3例(11%), 1例脑萎缩加重; 11例颅骨骨髓浸润消失。
结论: ALL患儿化疗前头颅MRI提示有颅骨骨髓浸润、脑萎缩和感觉传导束异常信号等, 以颅骨骨髓浸润为主, 治疗后部分能恢复。