Investig Magn Reson Imaging.  2016 Sep;20(3):167-174. 10.13104/imri.2016.20.3.167.

Enhancement of Optic Nerve in Leukemic Patients: Leukemic Infiltration of Optic Nerve versus Optic Neuritis

• Ra YH
• Park SY
• Im SA
• Kim JY
• Chung NG
• Cho B

• KMID: 2354797
• DOI: http://doi.org/10.13104/imri.2016.20.3.167

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.

Keyword

Leukemia; Magnetic resonance imaging; Optic nerve; Optic neuropathy

MeSH Terms

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

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