VBM Study Of Brain Changes After Intrathecal Prophylactic Chemotherapy In Children With ALL

Objective: To explore the changes of brain gray matter volume and white matter volume after intrathecal prophylactic chemotherapy in the central nervous system of children with acute lymphoblastic leukemia(ALL),in order to provide a theoretical basis for prophylactic chemotherapy-induced brain injury.Methods: The clinical data and magnetic resonance images of 34 children in the ALL case group and 34 normal control(NC)children whose gender and age were matched with those in the ALL group were collected.completed within a month.108 normal children were recruited and divided into 35 cases in the preschool age group(2-5 years old)and73 cases in the school age group(6-14 years old).Whole brain volume,relative grey matter volume and relative white matter volume for 83 brain regions were calculated using voxel-morphometry(VBM).The whole brain volume,relative gray matter volume and relative white matter volume between the preschool-age group and the school-age group were compared between groups,which were in line with normal distribution and homogeneity of variance,and performed two-sample T test;Test;Mann-Wilney U test was performed for not conforming to normal distribution.The whole brain volume,relative gray matter volume and relative white matter volume of children in the ALL group and NC group were compared between groups,and the paired samples T test was performed in accordance with the normal distribution,otherwise,the Wilcoxon signed rank test was performed.Results: Compared with school-aged children,the whole brain volume of pre-middle-aged children in normal children was smaller than that of school-aged children;the relative gray matter volume of preschool-aged children was larger than that of school-aged children;the relative white-matter volume of preschool-aged children was smaller than that of school-aged children.Compared with the children in the NC group,there was no significant difference in the whole brain volume between the ALL group and the NC group.Conclusion: There are differences in the volume of brain tissue in normal children in different age groups.Intrathecal prophylactic chemotherapy in the central nervous system of children with acute lymphoblastic leukemia affects the volume of gray matter and white matter in some brain regions,which may be the structural basis of brain injury.