Enhancement of Optic Nerve in Leukemic Patients: Leukemic Infiltration of Optic Nerve versus Optic Neuritis.
10.13104/imri.2016.20.3.167
- Author:
Yo Han RA
1
;
Sun Young PARK
;
Soo Ah IM
;
Jee Young KIM
;
Nak Gyun CHUNG
;
Bin CHO
Author Information
1. Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. saim@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Leukemia;
Magnetic resonance imaging;
Optic nerve;
Optic neuropathy
- MeSH:
Biopsy;
Bone Marrow;
Central Nervous System;
Cerebrospinal Fluid;
Diagnosis;
Humans;
Leukemia;
Leukemic Infiltration*;
Magnetic Resonance Imaging;
Optic Nerve Diseases;
Optic Nerve*;
Optic Neuritis*;
Precursor Cell Lymphoblastic Leukemia-Lymphoma;
Recurrence;
Retrospective Studies;
Sarcoma, Myeloid
- From:Investigative Magnetic Resonance Imaging
2016;20(3):167-174
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To identify magnetic resonance imaging (MRI) findings of leukemic infiltration of optic nerve and optic neuritis in leukemic patients with emphasis of clinical findings as reference standard to differentiate them. MATERIALS AND METHODS: MRI and clinical findings of 7 patients diagnosed as leukemic infiltration of optic nerve (n = 5) and optic neuritis (n = 2) in our institution between July 2006 and August 2015were reviewed retrospectively. In particular, MR imaging findings involved perineural enhancement and thickening of optic nerve and its degree, signal intensity, laterality (unilateral/bilateral), intraconal fat infiltration and its degree, and associated central nervous system abnormalities. RESULTS: Of 5 cases of leukemic infiltration of optic nerve, 4 cases showed positive cerebrospinal fluid (CSF) study for leukemia relapse and 1 case was positive on bone marrow (BM) biopsy only. Moreover, of 5 leukemic infiltration of optic nerve, 2 cases showed the most specific MR findings for leukemic central nervous system involvement including 1 prominent leptomeningeal enhancement and 1 chloroma. However, other MR imaging findings of the patients with leukemic infiltration or optic neuritis such as thickening and perineural enhancement of optic nerves are overlapped. CONCLUSION: Enhancement and thickening of optic nerve were overlapped MR findings in leukemic infiltration of optic nerve and optic neuritis. Our findings suggest that enhancing optic nerve thickening with associated central nervous system MR abnormality favors the diagnosis of leukemic infiltration of optic nerve, especially in patients with history of acute lymphoblastic leukemia. However, CSF and BM study were required for differentiation between leukemic infiltration of optic nerve and optic neuritis.
