Ultra-high-field MR imaging in polymicrogyria and epilepsy.
Ultra-high-field MR imaging in polymicrogyria and epilepsy.
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DOI：
10.3174/ajnr.a4116
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发表时间：
2015-03
期刊：
影响因子：
--
通讯作者：
Guerrini R
中科院分区：
文献类型：
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作者：
De Ciantis A;Barkovich AJ;Cosottini M;Barba C;Montanaro D;Costagli M;Tosetti M;Biagi L;Dobyns WB;Guerrini R
多小脑回是一种皮质发育畸形，常见于患有癫痫或发育迟缓的儿童。我们在体内研究了 7T 成像在描述多小脑回特征方面的潜力，以确定是否可以识别其他特征。之前使用 3T MR 成像诊断出的 10 名患有多小脑回症的成年患者在 7T 下接受了额外的成像。我们根据地形模式、范围、对称性和形态来评估多小脑回。 7T 的其他成像序列包括 3D T2* 磁敏加权血管造影和 2D 组织边界增强 FSE 反转恢复。最小强度投影用于评估磁敏感加权血管造影序列描绘脑静脉的潜力。在 7T 时，我们观察到 6 例患者为双侧侧裂周围多小脑回，3 例为单侧，1 例为弥漫性。6 例双侧异常中的 4 例在 3T 时被认为是单侧。 3T 成像显示 2 种形态类别（粗糙、精细），而 7T 磁敏感加权血管造影图像显示均匀的带状图案。磁敏感加权血管造影显示所有多微回区域有大量扩张的浅静脉。组织边界增强成像描绘了与灰白色界面相对应的低信号线，提供了边界的高清晰度，从而改善了多小回皮质的检测。与 3T 常规序列相比，7T 成像揭示了更多的多小脑回解剖细节，对相关癫痫的诊断、遗传学研究和手术治疗具有潜在意义。皮质静脉的异常可能提示血管发育不全在发病机制中的作用。
Polymicrogyria is a malformation of cortical development that is often identified in children with epilepsy or delayed development. We investigated in vivo the potential of 7T imaging in characterizing polymicrogyria to determine whether additional features could be identified. Ten adult patients with polymicrogyria previously diagnosed by using 3T MR imaging underwent additional imaging at 7T. We assessed polymicrogyria according to topographic pattern, extent, symmetry, and morphology. Additional imaging sequences at 7T included 3D T2* susceptibility-weighted angiography and 2D tissue border enhancement FSE inversion recovery. Minimum intensity projections were used to assess the potential of the susceptibility-weighted angiography sequence for depiction of cerebral veins. At 7T, we observed perisylvian polymicrogyria that was bilateral in 6 patients, unilateral in 3, and diffuse in 1. Four of the 6 bilateral abnormalities had been considered unilateral at 3T. While 3T imaging revealed 2 morphologic categories (coarse, delicate), 7T susceptibility-weighted angiography images disclosed a uniform ribbonlike pattern. Susceptibility-weighted angiography revealed numerous dilated superficial veins in all polymicrogyric areas. Tissue border enhancement imaging depicted a hypointense line corresponding to the gray-white interface, providing a high definition of the borders and, thereby, improving detection of the polymicrogyric cortex. 7T imaging reveals more anatomic details of polymicrogyria compared with 3T conventional sequences, with potential implications for diagnosis, genetic studies, and surgical treatment of associated epilepsy. Abnormalities of cortical veins may suggest a role for vascular dysgenesis in pathogenesis.