儿童白血病中枢神经系统并发症的CT及MRI表现

CT and MRI manifestations of central nervous system complications in childhood leukemia

目的探讨儿童白血病中枢神经系统并发症行CT及MRI检查的影像学特征。方法回顾性选择郑州大学附属儿童医院于2017-10—2019-10收治的白血病中枢神经系统并发症患儿38例作为临床资料,血管性病变19例,颅脑浸润16例,脑白质病变2例,二次肿瘤1例,均行CT及MRI检查,分析不同中枢神经系统并发症检出情况,观察CT影像特征及MRI影像特征。结果血管性病变含脑出血15例,CT为点片状高密度影,MRI为T1WI高信号或混杂信号;脑梗死4例,CT为基底核区及额顶叶片状低密度影,MRI为T1WI低信号,T2WI等信号。颅脑浸润含硬脑膜浸润8例,伴颅骨浸润5例,CT为病灶呈现高密度灶,MRI为T1WI低信号T2WI中等信号;脑实质浸润1例,CT为高密度肿块,MRI为TWI低信号,FLAIR高信号。软脑膜浸润2例,CT为条状的低密度灶,MRI为TWI低信号,DWI较高信号。脑白质病变MRI扫描脑白质T2WI高信号。二次肿瘤MRI为T1WI稍低信号,T2WI稍高信号。结论采用CT及MRI检查儿童白血病中枢神经系统并发症可发现中枢神经系统异常影像特征,对判断并发症类型提供可靠的依据,MRI相对显像更加详细,且对脑白质病变、二次肿瘤有检出作用,应用价值更高。

Objective To investigate the imaging characteristics of CT and MRI in children with central nervous system complications of leukemia.Methods From October 2017 to October 2019,38 children with central nervous system complications of leukemia admitted to our hospital were selected as the data.There were 19 cases of vascular diseases,16 cases of brain infiltration,2 cases of brain white matter diseases and 1 case of secondary tumor.CT and MRI examinations were performed to analyze the detection of different central nervous system complications,and the CT and MRI imaging features were observed.Results There were 15 cases of vascular diseases including cerebral hemorrhage,4 cases of cerebral infarction,4 cases of basal nuclei and frontal parietal lobes,4 cases of cerebral infarction,and 4 cases of cerebral infarction.Brain infiltration included dural infiltration in 8 cases,accompanied by skull infiltration in 5 cases.CT showed high-density focus,MRI showed low signal T2WI moderate signal on T1WI;brain parenchyma infiltration in 1 case,CT showed high-density mass,MRI showed low signal TWI,high signal FLAIR.There were 2 cases of pial infiltration.CT showed strip low density focus,MRI showed low signal of twi and high signal of DWI.The high signal of T2WI in white matter was detected by MRI.The MRI of the second tumor showed slightly low signal on T1WI and slightly high signal on T2WI.Conclusion CT and MRI examination of central nervous system complications in childhood leukemia can find the abnormal imaging characteristics of central nervous system,provide reliable basis for judging the type of complications.MRI is more detailed than imaging,and has a detection effect on leukoencephalopathy and secondary tumor,so it has higher application value.