Purpose or Case Report: To identify the main neuroimaging findings using MRI on pediatric patients with known diagnosis of leukemia at our institution during a period of 4 years.
Methods & Materials: We retrospectively evaluated all patient with confirmed diagnosis of leukemia and included all patients with neurologic symptoms whom MRI were performed. Findings were divided in primary (effects related to leukemia) and secondary (therapeutic effects).
Results: From the 197 patients with Leukemia, 37 had clinical neurologic symptoms and imaging of the brain. The average age was 8.37 years (+/- 4.2), from 1.8 to 15 years old. 17 females, 20 males. We found 31 patients with Acute Lymphocytic Leukemia (ALL), 3 with Acute Myeloid Leukemia (AML) and 3 with Mixed-phenotype Acute Leukemia. Intense headache was the most common symptom reported in 16 patients, follow by epilepsy in 10 patients. In the group of manifestations of primary disease we had 19 findings, the main findings were meningeal infiltration (7), parenchymal hemorrhage (3), optic nerve infiltration (3) and chloroma (3). In the group of therapeutic effects we had 32 findings, being the most frequent cortical atrophy (12), parenchymal hemorrhage (6), PRES (5) and leukoencephalopathy (4).
Conclusions: The most frequent neuroimaging findings in patients with leukemia were related to therapeutic effects with cortical atrophy and parenchymal hemorrhage. These were followed by changes related to primary disease such as meningeal infiltration, parenchymal hemorrhage, optic nerve infiltration and chloroma. To be aware of more frequent CNS manifestations of leukemia is crucial for radiologists, in order to ensure an accurate diagnosis and prompt treatment.