Diffusion Restriction in the Splenium: A Comparative Study of Cytotoxic Lesions of the Corpus Callosum (CLOCCs) versus Lesions of Vascular Etiology.
Diffusion Restriction in the Splenium: A Comparative Study of Cytotoxic Lesions of the Corpus Callosum (CLOCCs) versus Lesions of Vascular Etiology.
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DOI：
10.3390/jcm12226979
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发表时间：
2023-11-08
影响因子：
3.9
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中科院分区：
文献类型：
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胼胝体细胞毒性病变（CLOCCs）具有广泛的鉴别诊断。鉴别这些病变与血管性病变具有重要的临床意义。我们在一项回顾性队列研究中比较了血管性脾病变和CLOCCs的临床和影像学特征和预后。我们检查了155例胼胝体脾扩散受限患者的临床和放射学特征和预后。血管病变患者（N = 124）年龄较大（64.1比34.6岁，p < 0.001），有bbb1血管危险因素（91.1%比45.2%,p < 0.001）， LDL和A1c水平较高，超声心动图异常（均p≤0.05）。CLOCCs （N = 31）更常见的是脾脏中线受累（p < 0.001），只有脾扩散受限（p < 0.001），而血管病因性病变更可能有多灶扩散受限（p = 0.002）。血管病变患者的住院死亡率显著高于血管病变患者（p = 0.04）。在血管病因中，心脏栓塞是最常见的卒中机制（29.8%）。我们的研究表明，胼胝体扩散受限病变的血管病因和CLOCCs与不同的基线、临床和放射学特征和结果相关。准确区分这些病变对于适当的治疗和二级预防很重要。
Cytotoxic lesions of the corpus callosum (CLOCCs) have broad differential diagnoses. Differentiating these lesions from lesions of vascular etiology is of high clinical significance. We compared the clinical and radiological characteristics and outcomes between vascular splenial lesions and CLOCCs in a retrospective cohort study. We examined the clinical and radiologic characteristics and outcomes in 155 patients with diffusion restriction in the splenium of the corpus callosum. Patients with lesions attributed to a vascular etiology (N = 124) were older (64.1 vs. 34.6 years old, p < 0.001) and had >1 vascular risk factor (91.1% vs. 45.2%, p < 0.001), higher LDL and A1c levels, and echocardiographic abnormalities (all p ≤ 0.05). CLOCCs (N = 31) more commonly had midline splenial involvement (p < 0.001) with only splenial diffusion restriction (p < 0.001), whereas vascular etiology lesions were more likely to have multifocal areas of diffusion restriction (p = 0.002). The rate of in-hospital mortality was significantly higher in patients with vascular etiology lesions (p = 0.04). Across vascular etiology lesions, cardio-embolism was the most frequent stroke mechanism (29.8%). Our study shows that corpus callosum diffusion restricted lesions of vascular etiology and CLOCCs are associated with different baseline, clinical, and radiological characteristics and outcomes. Accurately differentiating these lesions is important for appropriate treatment and secondary prevention.
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影响因子：
2.8
作者：
Wilson, C. A.;Mullen, M. T.;Messe, S. R.
通讯作者：
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