Radiographic manifestations and clinical relevance to central nervous system complications of leukemia in chilQ dren / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the radiographic manifestations and clinical relevance to central nervous system complications of leukemia(CNSCL)in children. Methods The CT and magnetic resonance imaging(MRI)fin﹣dings and clinical features of 49 pediatric patients with CNCSL in Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine from May 2010 to June 2018 were retrospectively analyzed. Results (1)Cerebrovascular abnormalities in 23 cases included hemorrhage(20 cases),infarction(2 cases)and sinus thrombosis(1 case). One case of epidural hematoma and 19 cases of intracerebral multiple bleeding were seen in the hemorrhage group,which demonstrated high－density on CT and different signal on MRI as time went by. Microhe﹣morrhage displayed as low signal on susceptibility weighted imaging.(2)Among 23 cases of leukemic infiltration,the dura and/or skull were involved in 18 cases,which presented as fusiform or mass,with high density on CT,low signal on T1WI,intermediate signal on T2WI and strong enhancement;6 leptomeningeal infiltration demonstrated as meningeal thickening and enhancement;2 parenchymal involvement manifested with high－density mass;2 oculomotor nerve and 1 optic nerve infiltration demonstrated thickening and enhancement.(3)White matter disease was seen in 2 cases,with hyper－intensity on T2WI.(4)One case of secondary tumor was glial tumor in the brainstem. Conclusions The radiographic manifestations of CNCSL in children are various. CT and MRI are of important diagnostic values. Choosing the best imaging examination method and sequence according to clinical symptoms and test results can provide more valuable information for clinical diagnosis and treatment.