急性淋巴细胞白血病（ALL）治疗后出现脑结构损伤；然而，其在新发阶段的变化仍不清楚。我们的目标是使用基于表面的形态测量 (SBM) 和基于束的空间统计 (TBSS) 来探索新发儿科 ALL 中白质 (WM) 和灰质 (GM) 的改变。35 例 ALL 和 33 例典型发展 (TD) ）前瞻性地招募儿童并进行三维 T1 加权和弥散张量 (DTI) 成像。比较组间 DTI 指标、皮质 GM 特征和深部 GM 核体积的差异。在 ALL 中，唯一增加的 FA 位于胼胝体（PFWE 校正 = 0.023）和左上放射冠（PFWE 校正 = 0.045）被提出。与 TD 相比，儿童 ALL 的皮质表面积 (CSA)、厚度 (CT) 以及眶回、边缘上回、颞中回和颞上回的体积显着减少（所有 CWP = 0.01）。此外，舌回和左侧中间沟第一处的 CT 和 CSA 分别增加（所有 CWP = 0.01）。儿童 ALL 的双侧丘脑、尾状核、海马和右壳核体积较小（PFDR 校正 < 0.05）。在新发儿童 ALL 中发现了广泛的脑结构异常，这表明疾病本身可导致脑结构损伤。研究揭示了儿童急性淋巴细胞白血病新发阶段白质完整性和灰质形态特征的改变。提示化疗前可能存在结构损伤。 MRI 是早期检测儿童急性淋巴细胞白血病脑结构损伤的一种灵敏方法。© 2024。作者获得国际儿科研究基金会 (International Pediatric Research Foundation, Inc.) 的独家许可。

Brain structure injury was presented in acute lymphoblastic leukemia (ALL) after treatment; however, its alterations in new-onset stage are still unclear. We aim to explore white matter (WM) and grey matter (GM) alterations using surface-based morphometry (SBM) and tract-based spatial statistics (TBSS) in new-onset pediatric ALL.Thirty-five ALL and 33 typically developing (TD) children were prospectively recruited and underwent three-dimensional T1-weighted and diffusion tensor (DTI) imaging. DTI metrics, cortical GM features, and deep GM nuclei volume were compared between groups differences.In ALL, the only increased FA in the body of corpus callosum (PFWE-corrected = 0.023) and left superior corona radiata (PFWE-corrected = 0.045) were presented. Relative to TDs, pediatric ALL presented a significant decrease in cortical surface area (CSA), thickness (CT), and volume in orbital gyri, supramarginal gyrus, middle temporal gyrus, and superior temporal gyrus (all CWP = 0.01). Additionally, increased CT and CSA were found in lingual gyrus and left sulcus intermedius primus, respectively (all CWP = 0.01). Smaller volumes in pediatric ALL were observed in bilateral thalamus, caudate, hippocampus, and right putamen (PFDR-corrected < 0.05).Widespread brain structural abnormalities were found in new-onset pediatric ALL, which suggest disease itself can cause brain structural injury.This study revealed the altered white matter integrity and gray matter morphology characteristics in childhood acute lymphoblastic leukemia on new-onset stage. It is suggested that there may be structural impairment before chemotherapy. MRI is a sensitive way for early detection on brain structural damage in childhood acute lymphoblastic leukemia.© 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.