Abstract
BackgroundLeukemia is one of the most common fatal diseases in pediatric oncology. Recently, advances in drug therapy have improved the prognosis of acute leukemia with event-free survival of up to 60%; however, complications and adverse effects of the disease and anti-leukemic treatment have also increased. The CNS complications of leukemia can be classified into those that developed directly or indirectly from the underlying leukemic process and those that can be related to antileukemic therapy. MRI had improved early detection of CNS complications and proper management. The study aims to characterize the MRI findings caused by the leukemic involvement of CNS structures and treatment-associated CNS complications and assess its value in early management and avoidance of long-term side effects.ResultsThe patient’s age ranged from 2 to 18 years with different types of leukemia classified regarding the time of presentation as pretreatment, during treatment phases, and post-treatment. Different MRI abnormalities were recorded and clinically correlated.ConclusionThe neurological complications of leukemia have common presenting symptoms but varying imaging abnormalities. To reach the correct diagnosis, the presenting signs, symptoms, and laboratory data must be considered along with the radiologic findings. A diagnostic algorithm using conventional, post-contrast MRI, MR venography, along with diffusion-weighted MRI was of great value in early detection and differentiation of different CNS lesions detected in pediatric patients with leukemia and post-treatment CNS complications.
Highlights
Leukemia is one of the most common fatal diseases in pediatric oncology
Magnetic resonance imaging (MRI) is known for its superior soft-tissue imaging; it was observed that MRI aided the characterization of central nervous system (CNS) lesions caused by the leukemic involvement of CNS structures and treatment-associated CNS complications and will lead to early management and prevention or minimizing the side effects of the disease [6]
The inclusion criteria were pediatric age group and confirmed cases of leukemia presented with neurological manifestations, while the exclusion criteria were patient over 18 years old and pediatric patient with leukemia but with no neurological manifestations
Summary
Leukemia is one of the most common fatal diseases in pediatric oncology. Recently, advances in drug therapy have improved the prognosis of acute leukemia with event-free survival of up to 60%; complications and adverse effects of the disease and anti-leukemic treatment have increased. The study aims to characterize the MRI findings caused by the leukemic involvement of CNS structures and treatment-associated CNS complications and assess its value in early management and avoidance of long-term side effects. Leukemia is a heterogeneous group of disorders, caused by a neoplastic transformation in blood cell precursors during their differentiation in bone marrow [1] It is the most prevalent malignancy in children and represents nearly 30% of all malignancies, with 75% of cases corresponding to acute lymphoblastic leukemia (ALL). MRI is known for its superior soft-tissue imaging; it was observed that MRI aided the characterization of CNS lesions caused by the leukemic involvement of CNS structures and treatment-associated CNS complications and will lead to early management and prevention or minimizing the side effects of the disease [6]. The purpose of this study is to analyze the MRI imaging features of these complications and interpreting these scans in view of clinical data to assess its value in early management
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