Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei Province, China.
Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei Province, China.
J Magn Reson Imaging. 2024 Mar;59(3):998-1007. doi: 10.1002/jmri.28872. Epub 2023 Jun 19.
Carotid stenosis, even in the clinically asymptomatic stage, causes cognitive impairment, silent lesions, and hemispheric changes. The corpus callosum (CC) is crucial for hemispheric cortical integration and specialization.
To examine if CC morphology and connectivity relate to cognitive decline and lesion burden in asymptomatic carotid stenosis (ACS).
Retrospective, cross-sectional.
33 patients with unilaterally severe (70%) ACS and 28 demographically and comorbidity-matched controls. A publicly available healthy adult lifespan (ages between 18 and 80; n = 483) MRI dataset was also included.
FIELD STRENGTH/SEQUENCE: A 3.0 T; T1 MPRAGE and diffusion weighted gradient echo-planar imaging sequences.
Structural MRI and multidomain cognitive data were obtained. Midsagittal CC area, circularity, thickness, integrity, and probabilistic tractography were calculated and correlated with cognitive tests and white matter hyperintensity. Fractional anisotropy, mean diffusivity (MD), and radial diffusivity were determined from DTI.
Independent two-sample t-tests, χ tests, Mann-Whitney U, locally weighted scatterplot smoothing (LOWESS) curve fit, and Pearson correlation. A P value < 0.05 was considered statistically significant.
Patients with ACS demonstrated significant reductions in callosal area, circularity, and thickness compared to controls. The callosal atrophy was significantly correlated with white matter hyperintensity size (r = -0.629, P < 0.001). Voxel-wise analysis of diffusion measures in the volumetric CC showed that ACS patients exhibited significantly lower fractional anisotropy and higher MD and radial diffusivity in the genu and splenium of the CC than controls. Further lifespan trajectory analysis showed that although the midsagittal callosal area, circularity, and thickness exhibited age-related decreases, the values in the ACS patients were significantly lower in all age groups.
Midsagittal callosal atrophy and connectivity reflect the load of silent lesions and the severity of cognitive decline, respectively, suggesting that CC degeneration has potential to serve as an early marker in ACS.
3 TECHNICAL EFFICACY STAGE: 2.
即使在临床无症状阶段，颈动脉狭窄也会导致认知障碍、无症状性病变和大脑半球变化。胼胝体（CC）对于大脑半球皮质整合和特化至关重要。
探讨无症状性颈动脉狭窄（ACS）患者的 CC 形态和连接是否与认知下降和病变负荷有关。
回顾性、横断面研究。
33 例单侧严重（70%）ACS 患者和 28 例在人口统计学和合并症方面匹配的对照组。还纳入了一个公开的健康成年人全生命周期（年龄 18-80 岁；n=483）的 MRI 数据集。
场强/序列：3.0T；T1 MPRAGE 和弥散加权梯度回波平面成像序列。
获得结构 MRI 和多领域认知数据。计算了正中矢状面 CC 面积、圆度、厚度、完整性和概率追踪，并与认知测试和脑白质高信号相关联。从 DTI 中确定各向异性分数（FA）、平均弥散度（MD）和径向弥散度。
独立样本 t 检验、卡方检验、Mann-Whitney U 检验、局部加权散点平滑（LOWESS）曲线拟合和 Pearson 相关。P 值<0.05 被认为具有统计学意义。
ACS 患者的胼胝体面积、圆度和厚度与对照组相比显著减小。胼胝体萎缩与脑白质高信号大小显著相关（r=-0.629，P<0.001）。对 CC 容积的弥散测量进行体素分析显示，ACS 患者的 CC 体部和压部的 FA 值显著低于对照组，MD 和径向弥散度值显著升高。进一步的全生命周期轨迹分析表明，尽管正中矢状面胼胝体面积、圆度和厚度表现出与年龄相关的下降，但 ACS 患者在所有年龄组中的值均显著降低。
正中矢状面胼胝体萎缩和连接分别反映了无症状性病变的负荷和认知下降的严重程度，提示 CC 退化有可能成为 ACS 的早期标志物。
3 技术功效分期：2。
