PDF(Pubmed)
Abstract：
Chemotherapy and radiotherapy are widely used in the treatment of central nervous system tumors and acute lymphocytic leukemia even in the pediatric population. However, such treatments run the risk of a broad spectrum of cognitive and neurological deficits. Even though the correlation with cognitive decline is still not clear, neuroradiological defects linked to white matter injury and vasculopathies may be identified. Thanks to the use of 7T MRI it is possible to better define the vascular pattern of the brain lesions with the added advantage of identifying their characteristics and anatomical localization, which, however, are not evident with a conventional brain scan. Moreover, the use of Quantitative Susceptibility Mapping (QSM) makes it possible to discriminate between calcium deposits on vessels (chemo-radiation-induced) and hemoglobin deposition in radio-induced cavernomas, speculating, as a result, about the pathophysiology of iatrogenic brain damage. We describe the case of a 9 year-old boy with a T-type acute lymphoid leukemia who had previously been treated with polychemotherapy and high-dose RT. To better define the child\'s neuroradiological pattern, 7T MRI and QSM were performed in addition to conventional imaging examinations. Our case report suggests the potential usefulness of a QSM study to distinguish radio-induced vascular malformations from mineralizing microangiopathy.
摘要：
化疗和放疗广泛应用于中枢神经系统肿瘤和急性淋巴细胞白血病的治疗，甚至在儿科人群中。然而,这样的治疗有广泛的认知和神经缺陷的风险。尽管与认知能力下降的相关性尚不清楚，可以发现与白质损伤和血管病变相关的神经放射学缺陷。由于使用7TMRI，可以更好地定义脑部病变的血管模式，并具有识别其特征和解剖定位的额外优势。which,然而,传统的脑部扫描并不明显。此外，定量敏感性图（QSM）的使用可以区分血管上的钙沉积（化学辐射诱导的）和放射性海绵瘤中的血红蛋白沉积，投机,因此,关于医源性脑损伤的病理生理学。我们描述了一个9岁的T型急性淋巴白血病男孩的病例，该男孩先前曾接受过多重化疗和大剂量RT治疗。为了更好地定义孩子的神经放射学模式，除常规影像学检查外，还进行了7TMRI和QSM。我们的病例报告表明，QSM研究可将放射性血管畸形与矿化微血管病区分开。
