The emergence of CD19-targeted chimeric antigen receptor-T (CAR-T) cell therapy has created a new era in the management of pediatric patients with refractory B-cell malignancies such as B-cell acute lymphoblastic leukemia. Immune effector cell-associated neurotoxicity syndrome (ICANS) is frequently encountered in the postinfusion period of CD19-targeted chimeric antigen receptor-T cell therapy and in some cases may be fatal. Knowledge related to the spectrum of imaging findings of CD19-targeted CAR-T cell therapy-related ICANS is, however, still very much lacking, underscoring the need for continued research in this area. In this review, we hope to provide an overview of current knowledge and provide an in-depth literature review related to this topic. A brief discussion of possible imaging differential diagnoses, specifically in children with acute lymphoblastic leukemia, will also be included. Illustrative cases for each imaging phenotype will be provided to facilitate a better understanding. A greater level of insight of the spectrum of imaging findings related to ICANS will improve patients’ management and enhance efforts to safely deliver CAR-T cell immunotherapy. It will also facilitate further studies to derive mechanistic insights of ICANS and potentially assist in the testing and monitoring of therapeutic interventions.

靶向CD19的嵌合抗原受体T（CAR-T）细胞疗法的出现为治疗难治性B细胞恶性肿瘤（例如B细胞急性淋巴细胞白血病）的小儿患者开辟了一个新时代。在靶向CD19的嵌合抗原受体T细胞治疗的输注后阶段经常遇到免疫效应细胞相关的神经毒性综合症（ICANS），在某些情况下可能是致命的。然而，仍然非常缺乏与CD19靶向的CAR-T细胞疗法相关的ICANS影像学表现谱相关的知识，这强调了在这一领域进行持续研究的必要性。在这篇综述中，我们希望提供当前知识的概述，并提供与该主题相关的深入文献综述。简要讨论可能的影像学鉴别诊断，特别是在患有急性淋巴细胞白血病的儿童中，也将包括在内。将提供每种成像表型的说明性案例，以促进更好的理解。对与ICANS相关的影像学发现范围的更深入了解将改善患者的管理，并加强安全实施CAR-T细胞免疫疗法的努力。它还将促进进一步的研究，以得出ICANS的机理见解，并可能有助于测试和监测治疗性干预措施。