基于集成磁共振成像的急性淋巴细胞性白血病儿童脑体积测量  

The Brain Structure Volume Estimation Based on Synthetic MRI in Pediatric Acute Lymphoblastic Leukemia

作　　者：候威锋 苏舒[1] 陈颖茜 钱龙 唐燕来 黄礼彬[3] 杨智云[1] 林丽萍[1] HOU Wei-feng;SU Shu;CHEN Ying-qian;QIAN Long;TANG Yan-lai;HUANG Li-bin;YANG Zhi-yun;LIN Li-ping(Department of Radiology,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China;Department of MR Research,GE Healthcare,Beijing 100020;Department of Pediatrics,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院放射科,广东广州510080 [2]GE医疗磁共振科研部,北京100020 [3]中山大学附属第一医院儿科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2023年第2期271-276,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(82001439);广东省自然科学基金(2022A1515011910)。

摘　　要：[目的]儿童急性淋巴细胞性白血病(ALL)常发生中枢神经系统(CNS)浸润。ALL患儿多表现出亚临床CNS浸润,常规方法难以早期检测。本研究旨在探讨基于集成磁共振成像(Sy MRI)脑容量参数在临床未检测出CNS浸润的ALL患儿中的变化。[方法]前瞻性收集ALL患儿36例和典型发育(TD)儿童29例,所有被试均行Sy MRI检查。使用Synthetic MR软件后处理并获得总白质体积、灰质体积、脑脊液体积等脑容量参数,用协方差分析评估组间差异。采用Spearman相关性分析探讨生物学特征与有统计学意义的脑容量参数的相关性。[结果]与TD儿童相比,ALL患儿的脑脊液体积增加(P_(FDR校正)=0.009)及灰质体积减小(P_(FDR校正)=0.027)。ALL患儿灰质体积/颅内体积与危险度分级呈中度负相关(r_(s)=-0.380,P=0.022)。[结论]临床未检测出CNS浸润的ALL患儿表现为脑脊液蓄积及灰质减少。这些新发现提示ALL患儿CNS浸润亚临床期的脑容量的变化,为探究ALL患儿CNS浸润的潜在机制及早期诊断提供新的方向。[Objective]Central nervous system(CNS)infiltration commonly occurs in children with acute lymphoblas⁃tic leukemia(ALL).Early subclinical CNS infiltration in pediatric ALL is hard to detect with conventional methods.This study aimed to investigate the changes of brain structure volume parameters based on Synthetic MRI(SyMRI)in pediatric ALL without clinically diagnosed CNS infiltration.[Methods]Thirty-six ALL and twenty-nine typically developing(TD)children were prospectively collected and all underwent SyMRI.The Synthetic MR software was used to obtain brain volu⁃metric parameters including total white matter volume(WMV),gray matter volume(GMV),cerebrospinal fluid(CSF)volume,etc.and their within-group differences were assessed by analysis of covariance.The Spearman correlation analysis was used to examine the correlation between biological characteristics and statistically significant brain volume parameters.[Results]ALL children showed increased CSF volume(P_(FDR-corrected)=0.009)and decreased GMV(P_(FDR-corrected)=0.027)when compared to TD children.We also found a moderately negative association between GMV/intracranial volume and risk classification in pediatric ALL(rs=-0.380,P=0.022).[Conclusions]Pediatric ALL without clinically diagnosed CNS infiltration presented with accumulation of CSF and reduction of gray matter.The brain volumetric changes in subclini⁃cal CNS infiltration of pediatric ALL provides a new attempt for exploring the underlying mechanism and early detection of CNS infiltration in pediatric ALL.

关 键 词：磁共振成像 急性淋巴细胞白血病 儿童 灰质 脑脊液 

分 类 号：R445.2[医药卫生—影像医学与核医学]