Le Bras Anthony, Proisy Maia, Kuchenbuch Mathieu, Gomes Constantin, Tréguier Catherine, Napuri Sylvia, Quehen Emmanuel, Bruneau Bertrand
Department of Medical Imaging, Hôpital Sud, CHU de Rennes, Rennes, France.
Department of Pediatric Neurology, Hôpital sud, CHU Rennes, Rennes, France.
Pediatr Radiol. 2018 Jul;48(7):999-1007. doi: 10.1007/s00247-018-4124-x. Epub 2018 Apr 17.
Reversible lesions of the corpus callosum with initial restricted diffusion on diffusion-weighted imaging (DWI) are rare and mainly described in the south Asiatic population.
The purpose of this study was to describe the clinical presentation, imaging findings, prognosis and etiology of transient restricted diffusion lesions of the corpus callosum in a series of Caucasian children.
Seven children presenting with a transient restricted DWI lesion of the corpus callosum were included. Their clinical presentations and paraclinical examinations were investigated in addition to their MRI findings during the acute phase and at follow-up.
Five patients initially presenting with prodromal flu-like symptoms were diagnosed with mild encephalopathy with reversible corpus callosum lesions, three of which were due to the influenza virus. For two patients (twins) with a stroke-like presentation and without febrile illness, a central nervous system manifestation of X-linked Charcot-Marie-Tooth disease with connexin 32 mutation was diagnosed. All patients had a good clinical prognosis without clinical sequelae or residual MRI lesion for all patients at follow-up.
A transient lesion of the corpus callosum with restricted diffusion should prompt the radiologist to suggest an infectious trigger in children. The prognosis of these patients was good with normalization of clinical symptoms and MRI without any specific treatment.
胼胝体可逆性病变在扩散加权成像（DWI）上最初表现为扩散受限，这种情况较为罕见，主要在南亚人群中有所描述。
本研究旨在描述一系列白种儿童中胼胝体短暂性扩散受限病变的临床表现、影像学表现、预后及病因。
纳入7例出现胼胝体短暂性扩散受限病变的儿童。除了急性期和随访期间的MRI表现外，还对他们的临床表现和辅助检查进行了调查。
5例最初表现为前驱性流感样症状的患者被诊断为轻度脑病伴胼胝体可逆性病变，其中3例由流感病毒引起。对于2例（双胞胎）表现为中风样症状且无发热性疾病的患者，诊断为伴有连接蛋白32突变的X连锁型夏科-马里-图斯病的中枢神经系统表现。所有患者临床预后良好，随访时所有患者均无临床后遗症或MRI残留病变。
胼胝体出现扩散受限的短暂性病变应促使放射科医生考虑儿童存在感染诱因。这些患者预后良好，临床症状和MRI表现均可恢复正常，无需特殊治疗。
