신경학적인 결함이 있었던 영아의 예후 판단에서 뇌량 크기의 중요성 = The significance of corpus callosal size in the estimation of neurologically abnormal infants

다국어 초록 (Multilingual Abstract)

Purpose:The development of the corpus callosum occupies the entire period of cerebral formation. The myelination pattern on magnetic resonance imaging (MRI) is very useful to evaluate neurologic development and to predict neurologic outcome in high risk infants. The thickness of the corpus callosum is believed to depend on the myelination process. It is possible to calculate the length and thickness of the corpus callosum on MRI. Thus, we can quantitatively evaluate the development of the corpus callosum. We investigated the clinical significance of measuring various portions of the corpus callosum in neonate with neurologic disorders such as hypoxic brain damage and seizure disorder.
Methods:Forty-two neonates were evaluated by brain MRI. We measured the size of the genu, body, transitional zone, splenium, and length of the corpus callosum. Each measurement was divided by the total length of the corpus callosum to obtain its corrected size. The ratio of corpus callosal length and the anteroposterior diameter of the brain was also measured.
Results:There was no statistical significance in the sample size of each part of the corpus callosum. However, the corrected size or the ratio of body of the corpus callosum correlated with periventricular leukomalacia and hypoxic ischemic encephalopathy.
Conclusion:The abnormal size of the corpus callosum showed a good correlation with periventricular leukomalacia and hypoxic ischemic encephalopathy in neonates. We can predict clinical neurological problems by estimation of the corpus callosum in the neonatal period. (Korean J Pediatr 2008;51:1205-1210)

다국어 초록 (Multilingual Abstract)

Purpose:The development of the corpus callosum occupies the entire period of cerebral formation. The myelination pattern on magnetic resonance imaging (MRI) is very useful to evaluate neurologic development and to predict neurologic outcome in high risk infants. The thickness of the corpus callosum is believed to depend on the myelination process. It is possible to calculate the length and thickness of the corpus callosum on MRI. Thus, we can quantitatively evaluate the development of the corpus callosum. We investigated the clinical significance of measuring various portions of the corpus callosum in neonate with neurologic disorders such as hypoxic brain damage and seizure disorder.
Methods:Forty-two neonates were evaluated by brain MRI. We measured the size of the genu, body, transitional zone, splenium, and length of the corpus callosum. Each measurement was divided by the total length of the corpus callosum to obtain its corrected size. The ratio of corpus callosal length and the anteroposterior diameter of the brain was also measured.
Results:There was no statistical significance in the sample size of each part of the corpus callosum. However, the corrected size or the ratio of body of the corpus callosum correlated with periventricular leukomalacia and hypoxic ischemic encephalopathy.
Conclusion:The abnormal size of the corpus callosum showed a good correlation with periventricular leukomalacia and hypoxic ischemic encephalopathy in neonates. We can predict clinical neurological problems by estimation of the corpus callosum in the neonatal period. (Korean J Pediatr 2008;51:1205-1210)

참고문헌 (Reference)

1 Byrd SE, "The clinical and radiological evaluation of absence of the corpus callosum" 10 : 65-73, 1990

2 Tomasch J, "Size, distribution, and number of fibers in the human corpus callosum" 119 : 119-135, 1954

3 Sheth RD, "Size of the corpus callosum in cerebral palsy" 6 : 180-183, 1996

4 Brody BA, "Sequence of central nervous system myelination in human infancy. I. An autopsy study of myelination" 46 : 283-301, 1987

5 Schaefer GB, "Quantitative morphometric analysis of brain growth using magnetic resonance imaging" 5 : 127-130, 1990

6 Barkovich AJ, "Pediatric neuroimaging. 2nd ed" Raven Press 107-175, 1995

7 Barkovich AJ, "Normal postnatal development of the corpus callosum as demonstrated by MR imaging" 9 : 487-491, 1988

8 Gilles FH, "Myelination in the neonatal brain" 7 : 244-248, 1976

9 Bodensteiner JB, "Macro cisterna magna: a marker for maldevelopment of the brain?" 4 : 284-286, 1988

10 Kogame S, "MR measurement of normal brain stem cerebellum and corpus callosum on midsagittal section" 34 : 1383-1387, 1989

11 Hayakawa K, "MR Imaging of spastic diplegia. The importance of corpus callosum" 37 : 830-836, 1996

12 Hayakawa K, "Kuriyama M, Matsuda T. Normal brain maturation in MRI" 12 : 208-215, 1991

13 Bodensteiner JB, "Hypoplasia of the corpus callosum: a study of 445 consecutive MRI scans" 9 : 47-49, 1994

14 Innocenti GM, "Growth and reshaping of axons in the establishment of visual callosal connections" 212 : 824-827, 1981

15 Rakic P, "Development of corpus callosum and cavum septi in man" 132 : 45-72, 1968

16 Coley BD, "Cystic periventricular leukomalacia of the corpus callosum" 27 : 583-585, 1997

17 Fujii Y, "Corpus callosum in developmentally retarded infants" 11 : 219-223, 1994

18 Fujii Y, "Corpus callosum development in preterm and term infants" 10 : 141-144, 1994

19 Jeret JS, "Clinicopathological findings associated with agenesis of the corpus callosum" 9 : 255-264, 1987

20 Schaefer GB, "Clinical and morphometric analysis of the hypoplastic corpus callosum" 48 : 933-936, 1991

21 Wang PP, "Callosal morphology concurs with neurobehavioral and neuropathological findings in two neurodevelopmental disorders" 49 : 407-411, 1992

22 Barkovich AJ, "Anormalies of the corpus callosum: Correlation with further anomalies of the brain" 151 : 171-179, 1988

23 Iai M, "A comparative magnetic resonance imaging study of the corpus callosum in neurologically normal children and children with spastic diplegia" 83 : 1086-1090, 1994