Doherty Michael J, Jayadev Sumie, Watson Nathaniel F, Konchada Ravi S, Hallam Dan K
Department of Neurology, The University of Washington, Seattle, USA.
Arch Neurol. 2005 Mar;62(3):433-7. doi: 10.1001/archneur.62.3.433.
Magnetic resonance imaging (MRI) may show discrete splenium abnormalities; however, the implications of this radiologic finding are unclear.
To describe causes, clinical presentations, and prognoses of midline splenium changes evident on MRI.
Retrospective case series.
Teaching hospital.
Medical records of 9 patients with MRI-noted splenium changes were studied; 60 additional published cases were accessed.
Sixty-nine cases were reviewed.
Clinical and imaging findings, causes, and prognosis.
Confusion (35 patients), ataxia (25 patients), and recent seizure (23 patients) were common. Causes included alcohol use, infections, hypoglycemia, trauma, salt abnormalities, and seizure. Twenty-eight patients had complete resolution, 23 improved, and 1 died. Diffusion-weighted imaging showed splenium abnormalities the best. Eleven of 12 patients showed decrease in apparent diffusion coefficient. Most improved clinically, as did their subsequent MRI studies.
Midline splenium changes are commonly seen on MRI diffusion-weighted imaging sequences. Multiple causes can result in splenium changes. Physicians should evaluate for glucose and electrolyte abnormalities, seizure risk, ongoing infectious or parainfectious process, and traumatic causes.
磁共振成像（MRI）可能显示胼胝体离散性异常；然而，这一影像学发现的意义尚不清楚。
描述MRI上明显的中线胼胝体改变的病因、临床表现和预后。
回顾性病例系列研究。
教学医院。
研究了9例MRI显示胼胝体改变患者的病历；另查阅了60例已发表病例。
对69例病例进行了回顾。
临床和影像学表现、病因及预后。
常见症状为意识模糊（35例患者）、共济失调（25例患者）和近期癫痫发作（23例患者）。病因包括饮酒、感染、低血糖、创伤、盐代谢异常和癫痫发作。28例患者完全恢复，23例有所改善，1例死亡。弥散加权成像对胼胝体异常显示最佳。12例患者中有11例表观扩散系数降低。大多数患者临床症状改善，后续MRI检查结果也有所改善。
在MRI弥散加权成像序列上常见中线胼胝体改变。多种病因可导致胼胝体改变。医生应评估血糖和电解质异常、癫痫发作风险、正在进行的感染或感染后过程以及创伤性病因。
