An MRI review of acquired corpus callosum lesions

Abstract

Lesions of the corpus callosum (CC) are seen in a multitude of disorders including vascular diseases, metabolic disorders, tumours, demyelinating diseases, trauma and infections. In some diseases, CC involvement is typical and sometimes isolated, while in other diseases CC lesions are seen only occasionally in the presence of other typical extra-callosal abnormalities. In this review, we will mainly discuss the MRI characteristics of acquired lesions involving the CC. Identification of the origin of the CC lesion depends on the exact localisation of the lesion(s) inside the CC, presence of other lesions seen outside the CC, signal changes on different MRI sequences, evolution over time of the radiological abnormalities, history and clinical state of the patient, and other radiological and non-radiological examinations.

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

“…These data are useful for differentiating MS lesions-which typically affect the inferior corpus callosum in an asymmetrical distribution-from vascular lesions. 83 Single-slab is otropic 3D T2-FL AIR (voxel size = 1 mm 3 ) could replace 2D T2-FLAIR sequences, as it combines the advantages of a single-slab mode and high spatial resolution, in an acquisition time appropriate for routine examination of patients (when long echo-train acquisition is used, and in combination with parallel imaging). In some studies, 3D T2-FLAIR has shown better performance than 2D T2-FLAIR for detecting MS lesions, possibly owing to the large number of thin contiguous slices acquired and the increased contrast-to-noise ratio.…”

Etiology of Corpus Callosum Lesions with Restricted Diffusion

“…The majority of vascular lesions noted in this study involved the splenium of the CC, which has been reported previously in smaller series as well [6,11]. This may reflect the slightly higher incidence of infarcts in the posterior cerebral artery versus anterior cerebral artery territory, although both are relatively rare, with anterior cerebral artery infarction accounting for only 0.6-3 % of all infarcts, [16,18,20,22] and posterior cerebral artery infarction accounting for 7-14 % of all infarcts [18,20].…”

“…The majority of tumors identified were primary CNS tumors such as glioblastoma multiforme or lymphoma, both of which commonly invade the CC [11]. Nonvascular CC lesions were more likely to have concomitant cortical T2/ FLAIR hyperintensities and be associated with gadolinium enhancement and mass effect on MRI, all of which are radiographic features often associated with CNS tumors.…”

“…The determination of etiology was based on the available clinical and radiographic information and thus may have been influenced by the biases of the authors interpreting the data or the primary team caring for the patient. In particular, specific MRI sequences [11]. In a case series of 69 patients with midline diffusion restriction in the splenium, the most common causes were nonvascular, such as alcoholism/malnutrition (especially Marchiafava-Bignami disease), seizure, and trauma [12].…”

Cerebral Vasospasm Manifesting as a Transient Lesion of the Splenium of the Corpus Callosum Secondary to Pituitary Apoplexy

“…Transient splenial lesions may also be a consequence of posterior reversible encephalopathy syndrome, the etiology of which includes hypertension and toxic/metabolic disturbance, radiation induced leukoencephalopathy, and recent seizures. In-born errors of metabolism and hereditary leukodystrophies may also involve the splenium, but diffuse involvement of other regions is present as well [1]. …”