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目的探讨3.0T磁共振扩散张量成像(DTI)研究急性淋巴细胞性白血病(ALL)儿童化疗前后大脑的临床价值。方法对30例初发ALL患儿及与之年龄、性别相匹配的30例正常儿童志愿者行DTI检查,观察患儿治疗前、完全缓解后(CR)与正常对照组间表观扩散系数(ADC)和各向异性分数(FA)值的变化。结果 ALL患儿治疗前及CR后ADC值在额叶及胼胝体压部差异有显著统计学意义,FA值仅在额叶及胼胝体膝部差异有显著统计学意义;ALL患儿标危(SR)组、中危(IR)组、重危(HR)组治疗CR后所有部位感兴趣区FA及ADC值差异均无显著统计学意义。结论 DTI能准确测定初发ALL化疗CR后ADC和FA等值的变化特征,是早期发现ALL患儿化疗所致白质脑病发生的有效手段。
Objective To investigate the clinical value of 3.0T magnetic resonance diffusion tensor imaging (DTI) in the brain of children with acute lymphoblastic leukemia (ALL) before and after chemotherapy. Methods DTI was performed on 30 children with primary ALL and 30 healthy volunteers matched with their age and sex. The DTI was measured before and after treatment in patients with complete remission (CR) and normal controls ADC) and anisotropic fraction (FA) values. Results There was significant difference in ADC value between frontal lobe and corpus callosum before and after CR in children with ALL. There was significant difference in FA between the frontal lobe and corpus callosum only, There was no significant difference in the FA and ADC values of all the regions of interest after treatment of CR in the group of IR, moderate risk (IR) and severe (HR). Conclusions DTI can accurately measure the changes of ADC and FA after initial CR chemotherapy and is an effective means to detect the incidence of leukoencephalopathy in children with ALL.