The Neuroradiology Journal 19: 301-305, 2006
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Focal Lesion in Splenium of Corpus Callosum on FLAIR MRI: Common Findings in Aged Patients G. GUO*,**, R. WU*,**, K. ter BRUGGE**, D.J. MIKULIS** * Dapartment of Medical Imaging, The Second Hospital, Shantou University Medical College; Shantou, China ** Department of Medical Imaging, The Toronto Western Hospital, University of Toronto; Toronto, Canada
Key words: hyperintensity, splenium of corpus callosum, FLAIR
SUMMARY – Focal high signal intensity in the splenium of the corpus callosum on fluid-attenuated inversion-recovery (FLAIR) images is generally considered an abnormal MR finding. The aim of this study was to determine the frequency of this finding in elderly patients and review the differentiation from other diseases with the similar findings. FLAIR images of 132 patients with suspect CNS disease were retrospectively reviewed. The changes in the splenium of corpus callosum, deep white matter lesions, periventricular matter lesions, infarcts, atrophy and age were analyzed, as well as history. Among the initial 132 patients, focal high signal intensity in the splenium was associated with aging, white matter changes, atrophy, and cognitive disorders. Focal high signal intensity in the splenium of the corpus callosum on FLAIR image is a common finding in elderly patients, especially in aged patients with cognitive disorders. The pathologic alterations were commonly described by the term of “leukoaraiosis”. Knowledge of this finding and differentiation from other lesions focusing on the splenium of corpus callosum may help avoid unnecessary invasive diagnostic and therapeutic intervention.
Introduction Focal high signal intensity in the splenium of the corpus callosum on fluid-attenuated inversion-recovery (FLAIR) images is generally considered an abnormal MR finding 1-3. Although few cases and investigations have been reported, such as multiple sclerosis, trauma, infarction, Marchiafava-Bignami disease, antiepileptic drugs, radiation and aging, may involve the splenium of corpus callosum 1-10, its pathogenesis has not been illustrated mainly due to no relation to current symptoms (ie., dementia) and no clear explanation of clinical history 4. It is important to be aware of the fact that these findings may occur in several diseases because it may help avoid unnecessary invasive diagnostic and therapeutic intervention. We reviewed a group of patients who suspected CNS disease, 1) to determine the frequency of the hyperintensity lesion in splenium of corpus callosum on FLAIR MR imag-
ing occur in suspected CNS disease; 2) to illustrate the probable mechanism; 3) to review the differentiation from other diseases which have the similar findings. Material and Methods Patients
Two hundred and thirty-four consecutive patients (from January 1, 2004 to February 28, 2004) underwent MR scans as part of their clinical evaluation for suspected CNS disease. One hundred and two patients were excluded because of clinical or radiographic evidence suggesting a history of chemo- and radiotherapy, intracranial tumor, multiple sclerosis (MS), or obstructive hydrocephalus. The remaining 132 patients (56 males, 76 females; age range from 9-90 years with an average of 59 years) were recruited in this study. A retrospective review 301
Focal Lesion in Splenium of Corpus Callosum on FLAIR MRI: Common Findings in Aged Patients
G. Guo
Figure 1 90-year-old woman with a confusion episode. FLAIR images (9002/166/0) showed bright focal of abnormal signal intensity in the anterior subependymal region of the splenium of the corpus callosum and periventricular white matter with mild brain atrophy.
Figure 2 78-year-old man with dementia. FLAIR images (9002/155/1) showed bright rim of abnormal signal intensity in the anterior subependymal region of the splenium of the corpus callosum with mild brain atrophy.
of medical records was undertaken for subjects with hyperintensity in the splenium of corpus callosum on FLAIR MR images.
losum). Chi-square (x2) test was used to analyze the differentiation of DWM lesions, periventricular matter alterations, infarcts, atrophy and the patients’ history between groups. P
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Focal Lesion in Splenium of Corpus Callosum on FLAIR MRI: Common Findings in Aged Patients G. GUO*,**, R. WU*,**, K. ter BRUGGE**, D.J. MIKULIS** * Dapartment of Medical Imaging, The Second Hospital, Shantou University Medical College; Shantou, China ** Department of Medical Imaging, The Toronto Western Hospital, University of Toronto; Toronto, Canada
Key words: hyperintensity, splenium of corpus callosum, FLAIR
SUMMARY – Focal high signal intensity in the splenium of the corpus callosum on fluid-attenuated inversion-recovery (FLAIR) images is generally considered an abnormal MR finding. The aim of this study was to determine the frequency of this finding in elderly patients and review the differentiation from other diseases with the similar findings. FLAIR images of 132 patients with suspect CNS disease were retrospectively reviewed. The changes in the splenium of corpus callosum, deep white matter lesions, periventricular matter lesions, infarcts, atrophy and age were analyzed, as well as history. Among the initial 132 patients, focal high signal intensity in the splenium was associated with aging, white matter changes, atrophy, and cognitive disorders. Focal high signal intensity in the splenium of the corpus callosum on FLAIR image is a common finding in elderly patients, especially in aged patients with cognitive disorders. The pathologic alterations were commonly described by the term of “leukoaraiosis”. Knowledge of this finding and differentiation from other lesions focusing on the splenium of corpus callosum may help avoid unnecessary invasive diagnostic and therapeutic intervention.
Introduction Focal high signal intensity in the splenium of the corpus callosum on fluid-attenuated inversion-recovery (FLAIR) images is generally considered an abnormal MR finding 1-3. Although few cases and investigations have been reported, such as multiple sclerosis, trauma, infarction, Marchiafava-Bignami disease, antiepileptic drugs, radiation and aging, may involve the splenium of corpus callosum 1-10, its pathogenesis has not been illustrated mainly due to no relation to current symptoms (ie., dementia) and no clear explanation of clinical history 4. It is important to be aware of the fact that these findings may occur in several diseases because it may help avoid unnecessary invasive diagnostic and therapeutic intervention. We reviewed a group of patients who suspected CNS disease, 1) to determine the frequency of the hyperintensity lesion in splenium of corpus callosum on FLAIR MR imag-
ing occur in suspected CNS disease; 2) to illustrate the probable mechanism; 3) to review the differentiation from other diseases which have the similar findings. Material and Methods Patients
Two hundred and thirty-four consecutive patients (from January 1, 2004 to February 28, 2004) underwent MR scans as part of their clinical evaluation for suspected CNS disease. One hundred and two patients were excluded because of clinical or radiographic evidence suggesting a history of chemo- and radiotherapy, intracranial tumor, multiple sclerosis (MS), or obstructive hydrocephalus. The remaining 132 patients (56 males, 76 females; age range from 9-90 years with an average of 59 years) were recruited in this study. A retrospective review 301
Focal Lesion in Splenium of Corpus Callosum on FLAIR MRI: Common Findings in Aged Patients
G. Guo
Figure 1 90-year-old woman with a confusion episode. FLAIR images (9002/166/0) showed bright focal of abnormal signal intensity in the anterior subependymal region of the splenium of the corpus callosum and periventricular white matter with mild brain atrophy.
Figure 2 78-year-old man with dementia. FLAIR images (9002/155/1) showed bright rim of abnormal signal intensity in the anterior subependymal region of the splenium of the corpus callosum with mild brain atrophy.
of medical records was undertaken for subjects with hyperintensity in the splenium of corpus callosum on FLAIR MR images.
losum). Chi-square (x2) test was used to analyze the differentiation of DWM lesions, periventricular matter alterations, infarcts, atrophy and the patients’ history between groups. P
