Abnormal corpus callosum: a sensitive and specific indicator of multiple sclerosis.

Abstract

The authors investigated whether identification of corpus callosal (CC) involvement might increase the specificity of magnetic resonance (MR) imaging in differentiating multiple sclerosis (MS) from other periventricular white matter diseases (PWDs). They prospectively evaluated 42 patients with MS and 127 control patients with other PWDs. Ninety-three percent of the MS patients demonstrated confluent and/or focal lesions involving the callosal-septal interface (CSI). These lesions characteristically involved the inferior aspect of the callosum and radiated from the ventricular surface into the overlying callosum. CSI lesions were optimally demonstrated on sagittal long repetition time (TR)/short echo time (TE) images and frequently (45% of cases) went undetected on axial images. Only 2.4% of the control patients had lesions of the CC. The authors conclude that midsagittal long TR/short TE images are highly sensitive and specific for MS and that callosal involvement in MS is more common than previously reported.

Fatigue and progression of corpus callosum atrophy in multiple sclerosis

“…In MS patients, CC atrophy is a common finding [17,38] and correlates with whole brain atrophy [38]. Among others, we recently showed that CC atrophy correlates with progression of disability in MS [29,36,41].…”

Brain Single Photon Emission Computed Tomography With Tc-99m MIBI or Tc-99m ECD in Comparison to MRI in Multiple Sclerosis

“…Clinical evidence or imaging testimony of 2 separated lesions in CNS (dissociation in place) and/or presence of distinct lesions during a period of time (dissociation in time) are highly restricted to MS. 2 Gean-Marton et al have also proposed that lesions in midsagittal long repetition time (TR)/short echo time (TE) images and involvement of corpus callosum are highly specific for MS rather than other periventricular WM disorders. 3 Fast spin-echo (FSE), fluid-attenuated inversion recovery (FLAIR) FSE, and short tau inversion recovery FSE are among the other modifications to MRI, which ameliorate the sensitivity and specificity of indicated MS plaques. 4 A combinational set of textural features application in image volumetric interpretation has also shown to be more accurate in distinguishing MS plaques from the normal appearing WM and normal WM.…”

Neuroimaging in Multiple Sclerosis

“…In hypoxic-ischemic diseases lesions follow arterial anatomy, such as borderzone or watershed lesions, lacunes, multifocal basal ganglia lesions and cortical infarcts whereas in multiple sclerosis are perivenular (Enzinger et al, 2006). Moreover, the corpus callosum is not usually involved in hypoxic-ischemic diseases, due to its rich blood supply; on the contrary, this is commonly affected in MS due to the large amount of myelinated fibres it contains, with characteristic involvement of callosalseptal interface (Gean-Marton et al, 1991). Infratentorial lesions are uncommon in smallvessel disorder, but when they occur they are typically located in the central part of the pons (Kwa et al, 1997).…”