Article Figures & Data
Figures
- Fig 1.
Patient 3. MR imaging findings at the time of neurologic event (A–C) and at follow-up 2 months later (D).
A, Axial fat-suppressed FLAIR image (TR = 9000 msec; TE = 112 msec; TI = 2500 msec; acq = 1) shows no abnormality.
B, Axial diffusion image (B = 1000 s/mm2) shows high signal intensity at site of restricted motion of water in the parietal white matter of both hemispheres.
C, Axial ADC map shows hypointensity at affected sites. ADC measurements 50 s/mm2 (normal = 95 s/mm2).
D, Axial fat suppressed FLAIR image (TR = 9000 msec; TE = 112 msec; 1 = 2500 msec; acq = 1) shows bilateral abnormally increased signal intensity in white matter, right greater than left.
Tables
Patient Sex Diagnosis Age at Diagnosis (years) Protocol and Phase of Treatment When Event Occurred 1 F HR-ALL 16.3 CCG-1961 consolidation 2 F Lymphoblastic lymphoma 14.8 CCG-A5791-like DI no. 1/1 3 M SR-ALL 6.8 CCG-1991 DI no. 1/2 4 M HR-ALL 16.4 CCG-1961 DI no. 2/2 5 F HR-ALL 12.7 CCG-1961 DI no. 2/2 6 M Large cell lymphoma 9.7 CCG-5961 Note.—F indicates female; M, male; ALL, acute lymphoblastic leukemia; HR, high-risk; SR, standard-risk; CCG, Children’s Cancer Group; DI, delayed intensification.
Patient Time between Diagnosis and Event (months) Event Time between IT MTX and Event (days) Time between Event and Initial MRI (days) 1st MRI DWI Findings Time between Initial and Follow-up MRI (days) Follow-up MRI FLAIR Findings Duration of Symptoms 1 2 R hemiparesis, headache, dysmetria 8 0 Restricted L > R 5 Increased 1 mo 2 8 Aphasia, headache, R hemiparesis 7 1 Restricted L > R ND ND 4 d 3 5 L hemiparesis 11 1 Restricted R > L 59 Increased 7 d 4 11 R hemiparesis 6 1 Restricted L only 4 Increased 7 d 5 11 R hemiparesis 7 2 Restricted L > R 20 Increased 7 d 6 3 Aphasia 11 1 Restricted R = L 23 Increased 1 d Note.—R indicates right; L, left; IT MTX, intrathecal methotrexate; DWI, diffusion-weighted imaging; ND, not done; FLAIR, fluid attenuated inversion recovery sequence.
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