Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, China.
Department of Neurology, Children's Hospital of Chongqing Medical University, Chongqing, China.
Clin Radiol. 2021 Feb;76(2):159.e9-159.e17. doi: 10.1016/j.crad.2020.09.009. Epub 2020 Oct 6.
To investigate the brain magnetic resonance imaging (MRI) features of children with haemophagocytic lymphohistiocytosis (HLH) with central nervous system (CNS) involvement, and to investigate the correlation with clinical biochemical tests.
Clinical and MRI data were collected from 118 children with HLH-CNS between January 2012 and June 2019. Patients were grouped according to their MRI findings, and statistical methods were used to test for correlations between the MRI findings and biochemical variables.
Patients were divided into three groups, including normal appearance (Group 1, 17/118), diffuse parenchymal volume loss (Group 2, 44/118), and brain parenchyma lesions (Group 3, 57/118) containing three subtypes of brain lesions and HLH-CNS complications. Comparing biochemical values among the three groups revealed a significant difference for all values (p<0.05), except for cell counts in the cerebrospinal fluid (CSF). A pairwise comparison further showed significant inter-group differences for most of the variables. Spearman's rank correlation coefficient also demonstrated that CSF cell counts (r=0.193, p=0.036), CSF microprotein content (r=0.379, p<0.001), serum aspartate aminotransferase (AST; r=0.521, p<0.001), serum lactate dehydrogenase (LDH; r=0.514, p<0.001) and activated partial thromboplastin time (APTT; r=0.326, p<0.001) correlated positively with the MRI groups, while platelet count (PLT; r=-0.633, p<0.001) and plasma fibrinogen (FIB; r=-0.258, p=0.005) correlated negatively.
Classification of brain MRI findings of HLH-CNS correlates well with the results of several key biochemical tests. Brain MRI is a promising method to elucidate illness severity and clinical outcomes.
探讨伴有中枢神经系统（CNS）受累的噬血细胞性淋巴组织细胞增生症（HLH）患儿的脑磁共振成像（MRI）特征，并探讨其与临床生化检查的相关性。
收集 2012 年 1 月至 2019 年 6 月期间 118 例 HLH-CNS 患儿的临床和 MRI 资料。根据 MRI 结果对患者进行分组，采用统计学方法检验 MRI 结果与生化变量之间的相关性。
患者分为三组，包括正常外观（第 1 组，17/118）、弥漫性实质体积丢失（第 2 组，44/118）和脑实质病变（第 3 组，57/118），包含三种类型的脑病变和 HLH-CNS 并发症。对三组的生化值进行比较，除脑脊液（CSF）细胞计数外，所有值均有显著差异（p<0.05）。两两比较进一步显示大多数变量存在显著的组间差异。Spearman 秩相关系数也表明 CSF 细胞计数（r=0.193，p=0.036）、CSF 微量蛋白含量（r=0.379，p<0.001）、血清天冬氨酸转氨酶（AST；r=0.521，p<0.001）、血清乳酸脱氢酶（LDH；r=0.514，p<0.001）和活化部分凝血活酶时间（APTT；r=0.326，p<0.001）与 MRI 组呈正相关，而血小板计数（PLT；r=-0.633，p<0.001）和血浆纤维蛋白原（FIB；r=-0.258，p=0.005）与 MRI 组呈负相关。
HLH-CNS 的脑 MRI 表现分类与几项关键生化检查结果密切相关。脑 MRI 是阐明疾病严重程度和临床结局的有前途的方法。
