Ultra-High-Field Targeted Imaging of Focal Cortical Dysplasia: The Intracortical Black Line Sign in Type IIb.


Journal

AJNR. American journal of neuroradiology
ISSN: 1936-959X
Titre abrégé: AJNR Am J Neuroradiol
Pays: United States
ID NLM: 8003708

Informations de publication

Date de publication:
12 2019
Historique:
received: 20 06 2019
accepted: 18 09 2019
pubmed: 16 11 2019
medline: 14 7 2020
entrez: 16 11 2019
Statut: ppublish

Résumé

Conventional MR imaging has limitations in detecting focal cortical dysplasia. We assessed the added value of 7T in patients with histologically proved focal cortical dysplasia to highlight correlations between neuropathology and ultra-high-field imaging. Between 2013 and 2019, we performed a standardized 7T MR imaging protocol in patients with drug-resistant focal epilepsy. We focused on 12 patients in whom postsurgical histopathology revealed focal cortical dysplasia and explored the diagnostic yield of preoperative 7T versus 1.5/3T MR imaging and the correlations of imaging findings with histopathology. We also assessed the relationship between epilepsy surgery outcome and the completeness of surgical removal of the MR imaging-visible structural abnormality. We observed clear abnormalities in 10/12 patients using 7T versus 9/12 revealed by 1.5/3T MR imaging. In patients with focal cortical dysplasia I, 7T MR imaging did not disclose morphologic abnormalities ( The high sensitivity of 7T T2*-weighted images provides an additional tool in defining potential morphologic markers of high epileptogenicity within the dysplastic tissue of focal cortical dysplasia IIb and will likely help to more precisely plan epilepsy surgery and explain surgical failures.

Sections du résumé

BACKGROUND AND PURPOSE
Conventional MR imaging has limitations in detecting focal cortical dysplasia. We assessed the added value of 7T in patients with histologically proved focal cortical dysplasia to highlight correlations between neuropathology and ultra-high-field imaging.
MATERIALS AND METHODS
Between 2013 and 2019, we performed a standardized 7T MR imaging protocol in patients with drug-resistant focal epilepsy. We focused on 12 patients in whom postsurgical histopathology revealed focal cortical dysplasia and explored the diagnostic yield of preoperative 7T versus 1.5/3T MR imaging and the correlations of imaging findings with histopathology. We also assessed the relationship between epilepsy surgery outcome and the completeness of surgical removal of the MR imaging-visible structural abnormality.
RESULTS
We observed clear abnormalities in 10/12 patients using 7T versus 9/12 revealed by 1.5/3T MR imaging. In patients with focal cortical dysplasia I, 7T MR imaging did not disclose morphologic abnormalities (
CONCLUSIONS
The high sensitivity of 7T T2*-weighted images provides an additional tool in defining potential morphologic markers of high epileptogenicity within the dysplastic tissue of focal cortical dysplasia IIb and will likely help to more precisely plan epilepsy surgery and explain surgical failures.

Identifiants

pubmed: 31727747
pii: ajnr.A6298
doi: 10.3174/ajnr.A6298
pmc: PMC6975359
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2137-2142

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : ErratumIn

Informations de copyright

© 2019 by American Journal of Neuroradiology.

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Auteurs

E Bartolini (E)

From the Department of Pediatric Neurology (E.B., C.B., A.B., R. Guerrini).
Neurology Unit (E.B.), USL Centro Toscana, Nuovo Ospedale Santo Stefano, Prato, Italy.

M Cosottini (M)

Department of Translational Research and New Technologies in Medicine and Surgery (M. Cosottini), University of Pisa, Pisa, Italy.

M Costagli (M)

IMAGO7 Research Foundation (M. Costagli), Pisa, Italy.

C Barba (C)

From the Department of Pediatric Neurology (E.B., C.B., A.B., R. Guerrini).

L Tassi (L)

Epilepsy Surgery Centre C. Munari (L.T.), Ospedale Niguarda, Milano, Italy.

R Spreafico (R)

Clinical Epileptology and Experimental Neurophysiology Unit (R.S., R. Garbelli), Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologico C. Besta, Milano, Italy.

R Garbelli (R)

Clinical Epileptology and Experimental Neurophysiology Unit (R.S., R. Garbelli), Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologico C. Besta, Milano, Italy.

L Biagi (L)

Istituto Di Ricovero e Cura a Carattere Scientifico Fondazione Stella Maris (L.B., R. Guerrini), Pisa, Italy.

A Buccoliero (A)

From the Department of Pediatric Neurology (E.B., C.B., A.B., R. Guerrini).

F Giordano (F)

Neurogenetics and Neurobiology Unit and Laboratories, and Pediatric Neurosurgery Unit (F.G.), Children's Hospital A. Meyer-University of Florence, Florence, Italy.

R Guerrini (R)

From the Department of Pediatric Neurology (E.B., C.B., A.B., R. Guerrini) r.guerrini@meyer.it.
Istituto Di Ricovero e Cura a Carattere Scientifico Fondazione Stella Maris (L.B., R. Guerrini), Pisa, Italy.

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