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Research ArticlePEDIATRICS

MR Imaging of the Brain in Patients Cured of Acute Lymphoblastic Leukemia—the Value of Gradient Echo Imaging

M.S.M. Chan, D.J. Roebuck, M.-P. Yuen, C.-K. Li and Y.-L. Chan
American Journal of Neuroradiology March 2006, 27 (3) 548-552;
M.S.M. Chan
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D.J. Roebuck
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M.-P. Yuen
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C.-K. Li
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Y.-L. Chan
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    Fig 1.

    Twenty-year-old woman diagnosed 14 years previously and treated with intrathecal MTX (total dose = 72 mg) and cranial radiation therapy (18 Gy). A, Transverse gradient echo image shows 2 lesions compatible with old hemorrhages (arrowheads). The structures indicated by the arrows are blood vessels. B, Transverse T2-weighted fast spin-echo image at the same level appears normal.

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    Fig 2.

    Twenty-seven-year-old man diagnosed 18 years previously and treated with intrathecal MTX (total dose = 300 mg) and cranial radiation therapy (24 Gy). On coronal FLAIR image, there is grade 1 leukoencephalopathy (arrows), defined as patchy, mildly increased signal intensity in the periventricular white matter, without involvement of the subcortical U-fibers.

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    Table 1:

    Clinical characteristic of ALL and control patients

    ALL PatientsControl PatientsStudent t test
    Number4222
    Number (%) male27 (64)15 (68)
    Age at examination (y)
        Range6.9–27.67.2–31.8P = .16
        Mean ± SD17.4 ± 4.615.4 ± 5.5
    Age at diagnosis (y)
        Range1.2–13.70.5–13.0P = .46
        Mean ± SD5.2 ± 2.95.9 ± 4.0
    Interval from diagnosis (y)
        Range5.0–18.85.6–20.4P = .015
        Mean ± SD12.2 ± 3.69.5 ± 4.2
    • Note:—ALL indicates acute lymphoblastic leukemia.

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    Table 2:

    Location of hemorrhages detected at gradient echo imaging in 42 long-term survivors of acute lymphoblastic leukemia

    RegionNumber (%)SubregionNumber
    Cerebral hemispheres51 (82%)Frontal lobe23
    Parietal lobe10
    Temporal lobe10
    Occipital lobe6
    Insula2
    Deep brain structures5 (8%)Corpus callosum2
    Pineal1
    Thalamus1
    Caudate nucleus1
    Posterior fossa6 (10%)Cerebellum5
    Brain stem1
    Total62 (100%)
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    Table 3:

    Detection of hemorrhages by different imaging sequences

    SequenceNo. of hemorrhagic foci detected
    Gradient echo62
    T2-weighted spin echo9
    Fluid-attenuated inversion recovery7
    T1-weighted spin echo3
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American Journal of Neuroradiology: 27 (3)
American Journal of Neuroradiology
Vol. 27, Issue 3
March, 2006
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M.S.M. Chan, D.J. Roebuck, M.-P. Yuen, C.-K. Li, Y.-L. Chan
MR Imaging of the Brain in Patients Cured of Acute Lymphoblastic Leukemia—the Value of Gradient Echo Imaging
American Journal of Neuroradiology Mar 2006, 27 (3) 548-552;

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MR Imaging of the Brain in Patients Cured of Acute Lymphoblastic Leukemia—the Value of Gradient Echo Imaging
M.S.M. Chan, D.J. Roebuck, M.-P. Yuen, C.-K. Li, Y.-L. Chan
American Journal of Neuroradiology Mar 2006, 27 (3) 548-552;
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