Investigation of the Corpus Callosum Index to Detect Atrophy and Hydrocephalus Patients in the Pediatric Age Group: Retrospective MRI Study

Abstract

Brain development and various pathological conditions affect corpus callosum (CC) morphology. Recent studies have suggested the CC index (CCI) as a marker for brain atrophy. In this study, we investigated the ability of linear measurements of CC, regional ratios, and normative data of CCI to discriminate between patients with atrophy and hydrocephalus in the pediatric period. For this retrospective study, we included patients aged 0-18 who underwent brain magnetic resonance imaging between 2012 and 2020 with a three-dimensional T1-weighted sequence. We included 722 individuals (340 females) with normal radiological anatomy for normal CC data, 30 patients for atrophy, and 25 for hydrocephalus. We measured the anteroposterior (AP) distance of the CC and the genu, truncus, and splenium thicknesses with 3D Slicer. We calculated regional CC ratios and CCI by dividing CC thicknesses by AP distance and analyzed the results with SPSS (ver.28). In the 0-18 age group, the normal mean CCI was 0.40. However, the CCI was between 0.29 and 0.39 in the first 30 months of life when brain development is sensitive. In the pediatric period, the cut-off value of CCI for brain atrophy was 0.37, while it was 0.29 for hydrocephalus. The fastest growth of regional CC thicknesses was between 7-18 months. Although the genu and truncus had similar developmental periods, the splenium had a different developmental period during adolescence. We think that our study's normative CC data and cut-off values before volumetric evaluation, which is complex and time-consuming in patients with brain atrophy and hydrocephalus, are instructive.

Keywords

• Corpus callosum
• Index
• Brain Atropy
• Hydrocephalus
• Pediatrics

Corpus Callosum İndeksinin Pediatrik Yaş Grubundaki Normatif Verilerinin Atrofi ve Hidrosefali Hastalarını Ayırt Edebilirliğinin Araştırılması: Retrospektif MRG Çalışması

Abstract

Beyin gelişimi ve çeşitli patolojik durumlar corpus callosum (CC) morfolojisini etkiler. Son çalışmalar, CC indeksini (CCİ) yetişkin multipl skleroz hastalarında beyin atrofisi için bir belirteç olarak önermişti. Ancak pediatrik dönemde beyin atrofisi ve hidrosefali durumunda CC’deki kantitatif veriler bildirilmemişti. Çalışmamızın amacı CC’nin doğrusal ölçümlerinin, bölgesel oranlarının ve CCİ’nin normatif verilerini oluşturup, atrofi ve hidrosefali hastalarında bu verilerdeki değişimi araştırmaktı. Bu retrospektif çalışmaya CC’nin normatif verileri için, 2012-2020 yılları arasında beyin manyetik rezonans görüntülemesi yapılan 0-18 yaş arası hastalardan üç boyutlu T1 ağırlıklı sekansı olup normal radyolojik anatomiye sahip 722 hastayı (340 [%47,09] kadın) seçtik. Patolojik CC değerlendirmesi için 30 atrofi ve 25 hidrosefali hastasını dahil ettik. CC’nin antero-posterior (AP) uzunluğunu, genu, truncus ve splenium kalınlıklarını 3D Slicer’la ölçtük. Bölgesel CC oranlarını ve CCİ’yi, CC kalınlıklarını AP uzunluğuna oranlayarak hesapladık ve sonuçları SPSS (ver.28) ile analiz ettik. 0-18 yaş grubunda normal CCİ ortalaması 0,40’dı. Ancak beyin gelişiminin hassas olduğu yaşamın ilk 30 ayında CCİ 0,29-0,39 arasındaydı. Pediatrik dönemde CCİ’nin beyin atrofisi için eşik değeri 0,37 iken, hidrosefali durumunda ise 0,29’du (p<0,001). Normal Genu/AP oranı 0,160; truncus/AP oranı 0,095; splenium/AP oranı ise 0,148’di. Bölgesel CC kalınlıklarının en hızlı büyümesi 7-18 ay arasındaydı. Genu ve truncus’un benzer gelişim dönemleri (0-6 ay, 7-18 ay, 19-48 ay, 4-18 yaş) olmasına rağmen splenium’un ergenlik döneminde ayrı bir gelişim dönemi vardı. Doğrusal CC ölçümlerinde ve indekslerinde cinsiyet faktörünün önemsiz olduğunu bulduk. Beyin atrofisi ve hidrosefali hastalarının tespitinde karmaşık ve zaman alıcı olan hacimsel değerlendirme öncesi çalışmamızın sunduğu CC normatif verilerinin ve eşik değerlerinin yol gösterici olduğunu düşünmekteyiz.

Keywords

• Corpus callosum
• İndeks
• Beyin atrofisi
• Hidrosefali
• Pediatri

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