Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Pekala, J. S. Articles by Raque, J. D. Search for Related Content PubMed PubMed Citation Articles by Pekala, J. S. Articles by Raque, J. D.

American Journal of Neuroradiology 24:855-861, May 2003
© 2003 American Society of Neuroradiology

BRAIN

Focal Lesion in the Splenium of the Corpus Callosum on FLAIR MR Images: A Common Finding with Aging and after Brain Radiation Therapy

Joseph S. Pekala^a, Alexander C. Mamourian^a, Heather A. Wishart^b, William F. Hickey^c and James D. Raque^d

^a Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
^b Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH
^c Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
^d Department of Radiology, Finley Hospital, Dubuque, IA

Address reprint requests to Joseph S. Pekala, MD, Department of Radiology, Dartmouth-Hitchcock Medical Center, One Medical Center Dr, Lebanon, NH 03756–00.1

BACKGROUND AND PURPOSE: 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. We identified high signal intensity in the splenium on FLAIR images in patients of advanced age with otherwise normal images and in patients who had received brain radiation therapy. We undertook an investigation to determine the frequency of this finding in these patient groups.

METHODS: We reviewed the FLAIR images and medical records of 67 patients (group 1) imaged for suspicion of CNS disease and of 18 consecutive patients (group 2) with history of brain radiation therapy. All FLAIR images were evaluated for focal signal intensity abnormalities in the splenium and for diffuse white matter abnormalities. Also, autopsy specimens from two cases not part of either study group were examined.

RESULTS: Among the initial 67 patients in group 1, focal high signal intensity in the splenium was associated with aging, radiation therapy, and white matter changes. Focal high signal intensity in the splenium was evident on FLAIR images in 16 of the 18 patients in the post-radiation therapy group. Histologic examination of the splenium in one autopsy case with a history of chest and neck radiation therapy demonstrated isomorphic gliosis.

CONCLUSION: High signal intensity in the splenium of the corpus callosum on FLAIR images is a common finding after brain radiation therapy and can be seen with aging. The radiologist should be aware of this common finding and not mistake it for more commonly recognized causes of splenial lesions.

This article has been cited by other articles:

				M. J. Doherty, S. Jayadev, N. F. Watson, R. S. Konchada, and D. K. Hallam Clinical Implications of Splenium Magnetic Resonance Imaging Signal Changes Arch Neurol, March 1, 2005; 62(3): 433 - 437. [Abstract] [Full Text] [PDF]

				J. C. Adair and R. R. Lee Abnormal Fluid-Attenuated Inversion Recovery Signal Foci in the Splenium of a Patient with Presenilin-1 Mutation AJNR Am. J. Neuroradiol., November 1, 2004; 25(10): 1864 - 1865. [Full Text] [PDF]

				A. Yamamoto, Y. Miki, Y. Fushimi, T. Okada, and H. Tomimoto Mid-Anterior Surface of the Callosal Splenium: Subependymal or Subpial? AJNR Am. J. Neuroradiol., April 1, 2004; 25(4): 664 - 665. [Full Text]