Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
In Vivo. 2022 May-Jun;36(3):1354-1359. doi: 10.21873/invivo.12838.
BACKGROUND/AIM: Various neurological disorders are associated with lesions predominantly or exclusively affecting the splenium of the corpus callosum (CC), such as Marchiafava-Bignami syndrome (MBS), reversible splenium lesion (RSL), and ischemic stroke (IS). The spectrum of symptoms is broad and clinical presentations may be indistinguishable. Therefore, we aimed to investigate the additional value of diffusion-weighted imaging (DWI) findings of splenial lesions in patients with MBS, RSL, and IS.
Overall, 23 patients (4 patients with MBS, 10 patients with RSL, and 9 patients with isolated IS in the splenium) were identified from a magnetic resonance imaging report database and analyzed with focus on lesion localization, shape, and size on DWI, as well as relative apparent diffusion coefficient (ADC).
A focal hyperintensity in the splenium was observed on DWI in all patients. In MBS symmetrical boomerang-shaped lesions, in RSL central oval or round lesions, and in IS eccentric irregular lesions in the splenium were found. The median lesion size in MBS [6.25 (IQR=2.04-8.62) ml] was significantly larger than that in RSL [0.38 (IQR=0.09-0.92) ml, p=0.01], and in IS [0.09 (IQR=0.05-0.94) ml; p=0.01]. Regarding relative ADC values, no significant differences between MBS [0.32 (IQR=0.19-0.62)], RSL [0.22 (IQR=0.14-0.30)], and IS [0.27 (IQR=0.20-1.19)] were found.
Diffusion restricted lesions in the splenium of the CC are best classified by localization, shape, and size, whereas relative ADC values are of limited value for differentiation of different neurological disorders.
背景/目的：各种神经疾病与主要或仅影响胼胝体压部（CC）的病变有关，例如 Marchiafava-Bignami 综合征（MBS）、可逆性胼胝体压部病变（RSL）和缺血性中风（IS）。症状谱广泛，临床表现可能难以区分。因此，我们旨在研究弥散加权成像（DWI）在 MBS、RSL 和 IS 患者中发现的胼胝体压部病变的附加价值。
我们从磁共振成像报告数据库中确定了 23 名患者（4 名 MBS 患者、10 名 RSL 患者和 9 名孤立性 IS 患者），并对其进行了分析，重点是 DWI 上病变的定位、形状和大小，以及相对表观扩散系数（ADC）。
所有患者的 DWI 上均观察到胼胝体高信号。在 MBS 中，发现对称的“之”字形病变，在 RSL 中，发现中央椭圆形或圆形病变，在 IS 中，发现偏心性不规则病变。MBS 组的中位数病变大小[6.25（IQR=2.04-8.62）ml]明显大于 RSL 组[0.38（IQR=0.09-0.92）ml，p=0.01]和 IS 组[0.09（IQR=0.05-0.94）ml；p=0.01]。关于相对 ADC 值，MBS [0.32（IQR=0.19-0.62）]、RSL [0.22（IQR=0.14-0.30）]和 IS [0.27（IQR=0.20-1.19）]组之间无显著差异。
CC 胼胝体压部弥散受限病变最好通过定位、形状和大小进行分类，而相对 ADC 值对不同神经疾病的鉴别价值有限。
