The Exploration of Glymphatic System Alteration in Pediatric Acute Lymphoblastic Leukemia Using DTI-ALPS Method
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2023.0312
- VernacularTitle:血管周围间隙扩散张量分析方法对急性淋巴性白血病患儿脑类淋巴系统改变的探讨
- Author:
Wei-feng HOU
1
;
Shu SU
1
;
Ying-qian CHEN
1
;
Long QIAN
2
;
Yan-lai TANG
3
;
Li-bin HUANG
3
;
Zhi-yun YANG
1
;
Li-ping LIN
1
Author Information
1. Department of Radiology， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510080， China
2. MR Research， GE Healthcare， Beijing 100020， China
3. Department of Pediatrics， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510080， China
- Publication Type:Journal Article
- Keywords:
acute lymphoblastic leukemia;
children;
central nervous system;
MRI;
the glymphatic system
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2023;44(3):456-461
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveThe glymphatic system regulates cerebral spinal fluid and interstitial fluid transport which might be one of the pathways of central nervous system （CNS） leukemia at the early stage. This study aimed to investigate the alteration of glymphatic system based on diffusion tensor image-analysis along the perivascular space （DTI-ALPS） in pediatric acute lymphoblastic leukemia （ALL） without clinically diagnosed CNS infiltration. MethodsTwenty-five ALL and typically developing （TD） children were prospectively recruited， and all subjects underwent DTI. Group differences in brain water diffusivities and ALPS-index were evaluated using the analysis of covariance. The Spearman correlation analysis was used to evaluate the relationship between biological characteristics and significant parameters in pediatric ALL. ResultsCompared with TDs， decreased Dxassoc value （PFDR-corrected = 0.048） and increased Dzassoc value （PFDR-corrected = 0.033） were found in pediatric ALL. Hence， lower ALPS-index was found in children with ALL （PFDR-corrected < 0.001）. ALPS-index was negatively associated with the risk classification （rs = -0.47， P = 0.018） as well as immunophenotype （rs = -0.40， P = 0.046） in pediatric ALL. ConclusionsOur results show dysfunction of the glymphatic system is presented in pediatric ALL without clinically diagnosed CNS infiltration， which suggests that the glymphatic system might be one of pathway in the early-stage of ALL CNS infiltration. The DTI-ALPS method can be used to evaluate the change of glymphatic system， providing a new method for exploring the underlying mechanisms and early detection of pediatric ALL CNS infiltration.
