Evidence map›Paper›PMID 37624411›Full record

ArticleEuropean radiology2024

Brain MRI imaging markers associated with death in children with central nervous system involvement of hemophagocytic lymphohistiocytosis.

Wei Ma, Liang Zhou, Wei Li, Xiujuan Li, Yan Huang, Sijie Gao, Jie Yu, Yuan Fang, Ye Xu

Abstract read
PubMed Publisher
In one paragraph

Article in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Wei MaDepartment of Radiology, The Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, 136 Zhongshan Er Lu, Yuzhong District, Chongqing, 400000, China.
Liang ZhouDepartment of Emergency, Children's Hospital of Chongqing Medical University, Yuzhong District, Chongqing, 400000, China.
Wei LiDepartment of Radiology, The Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, 136 Zhongshan Er Lu, Yuzhong District, Chongqing, 400000, China.
Xiujuan LiDepartment of Neurology, Children's Hospital of Chongqing Medical University, Yuzhong District, Chongqing, 400000, China.
Yan HuangDepartment of Radiology, The People's Hospital of Yubei District of Chongqing City, Yubei District, Chongqing, 400000, China.
Sijie GaoDepartment of Radiology, The Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, 136 Zhongshan Er Lu, Yuzhong District, Chongqing, 400000, China.
Jie YuDepartment of Hematology, Children's Hospital of Chongqing Medical University, Yuzhong District, Chongqing, 400000, China.
Yuan FangDepartment of Radiology, The People's Hospital of Yubei District of Chongqing City, Yubei District, Chongqing, 400000, China.
Ye XuDepartment of Radiology, The Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, 136 Zhongshan Er Lu, Yuzhong District, Chongqing, 400000, China. yexu@cqmu.edu.cn.ORCID http://orcid.org/0000-0002-4498-0245
China International Science and Technology Cooperation · CNChildren's Hospital of Chongqing Medical University · CNFirst People's Hospital of Chongqing · CN

Funding

Chongqing Science and Technology Commission cstc2016 shmszx130009Chongqing Science and Technology Foundation cstc2018jscx-msybX0069National Natural Science Foundation of China 81301300
6 · The paper itself

Abstract

objectivesTo investigate the association of brain MRI and clinical variables with death in children with central nervous system involvement of hemophagocytic lymphohistiocytosis (CNS-HLH).

methodsClinical and brain MRI data of children with CNS-HLH from January 2012 to March 2022 were reviewed retrospectively. Patients were divided into the deceased group and the surviving group. The intergroup differences of seven brain MRI variables, twelve clinical variables, and underlying diseases were studied.

resultsOne hundred and fourteen patients were included in this study, consisting of 59 who died and 55 who survived. The included clinical variables did not show statistically independent correlation with patients' deaths. For MRI variables, a multivariate analysis demonstrated restricted diffusion of lesion (OR = 9.64, 95% CI: 3.39-27.43, p < 0.001) and count of affected brain regions (CABR) (OR = 1.24, 95% CI: 1.03-1.49, p = 0.02) were independent risk factors for death. ROC curve showed CABR (AUC = 0.79, 95% CI: 0.70-0.87, p < 0.001) is highly predictive for mortality with an optimal cutoff value of 4.5 (sensitivity 76%, specificity 73%). For HLH subtypes, familial HLH (F-HLH, OR = 9.90, 95% CI: 2.01-48.87, p = 0.005) and immune-compromise-related HLH (IC-HLH, OR = 4.95, 95% CI: 1.40-17.46, p = 0.01) presented statistically stronger association with death than infection-related HLH. F-HLH and IC-HLH preferred to have large lesions, restricted diffusion, and more brain regions involved than other subtypes.

conclusionBrain MRI features exhibit independent prediction for mortality in children with CNS-HLH, and HLH subtypes pose effects on patient outcomes and brain MRI findings. CLINICAL RELEVANCE STATEMENT: The number of affected brain regions and diffusion restriction of lesion exhibit significant correlation with mortality in children diagnosed with CNS-hemophagocytic lymphohistiocytosis, and may serve as candidate MRI markers for the prediction of the disorder's severity. KEY POINTS: • The brain MRI markers, restricted diffusion of lesion and count of affected brain regions, significantly correlated with death. • Familial and immune-compromise-related hemophagocytic lymphohistiocytosis presented statistically stronger association with death than infection-related subtype. • Brain MRI is potential in death-predicting for children with central nervous system involvement of hemophagocytic lymphohistiocytosis.

Indexed as

Lymphohistiocytosis, HemophagocyticBrainChildHumansMagnetic Resonance ImagingRetrospective StudiesRisk FactorsCentral nervous systemChildHemophagocytic lymphohistiocytosisMagnetic resonance imagingRisk factors

Identifiers

PMID37624411
OpenAlexW4386150936

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.