白血病治疗相关的颅脑并发症MRI表现  

MRI manifestations of therapy-induced cerebral complications in leukemia

作　　者：陈皓[1] 洪楠[1] 孙超[1] 权光南[1] 

机构地区：[1]北京大学人民医院放射科,北京100044

出　　处：《中国医学影像技术》2011年第4期706-709,共4页Chinese Journal of Medical Imaging Technology

基　　金：新世纪优秀人才支持计划(985-2-086-113)

摘　　要：目的探讨白血病治疗相关颅脑并发症的MRI表现,分析其可能原因。方法 24例经骨髓穿刺证实的白血病患者接受颅脑MR检查,回顾性分析其MRI表现及随访后变化,并结合白血病治疗过程及并发症诊治过程分析其可能原因。结果 MRI发现24例患者均有颅脑并发症,其中17例存在2种或以上并发症,包括颅内出血2例,脑梗死2例,脑白质脱髓鞘病变12例,脑萎缩17例,可逆性后部白质脑病综合征6例,真菌感染4例。其发生可能与化疗药及骨髓移植后免疫抑制有关。结论化疗药的神经毒性和移植后免疫功能受抑状态是导致白血病颅脑并发症的重要原因。MRI是诊断和随访这些并发症的有效手段。Objective To investigate the MRI features of cerebral complications induced by therapy in leukemia,and to analyze the causes of these complications.Methods Twenty-four leukemia patients underwent cerebral MR examinations,the images were reviewed retrospectively to diagnose and follow up the complications,then possible causes of the complications were analyzed according to medical records.Results Among 24 patients,17 had two or more different complications,including intracranial hemorrhage（n=2）,cerebral infarction（n=2）,leukoencephalopathy（n=12）,cerebral atrophy（n=17）,posterior reversible encephalopathy syndrome（n=6） and fungal infection（n=4）.Neurotoxicity of chemotherapeutic regimens and immunosuppression after bone marrow transplantation might be related to these complications.Conclusion Chemotherapy and immunosuppression might be the causes for cerebral complications in leukemia.MRI is an effective method to detect and follow up these complications.

关 键 词：白血病 化学治疗 骨髓移植 并发症 磁共振成像 

分 类 号：R733.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]