Pilot Study of Voxel-Based Morphometric MRI Post-processing in Patients With Non-lesional Operculoinsular Epilepsy
Pilot Study of Voxel-Based Morphometric MRI Post-processing in Patients With Non-lesional Operculoinsular Epilepsy
复制标题
基于体素的形态测量 MRI 后处理对非病变岛叶癫痫患者的初步研究
DOI：
10.3389/fneur.2020.00177
复制
发表时间：
2020-03
影响因子：
3.4
通讯作者：
Wang Yuping
中科院分区：
文献类型：
--
作者：
Wang Wei;Zhou Qilin;Zhang Xiating;Li Liping;Xu Cuiping;Piao Yueshan;Wu Siqi;Wang Yajie;Du Wei;Zhao Zhilian;Lin Yicong;Wang Yuping
目标：本研究的目的是使用基于体素的MRI后处理技术检测术前MRI阴性的耐药岛盖癫痫患者的细微FCD，并结合脑磁图（MEG）提高致痫灶的定位。方法：术前MRI阴性的岛叶癫痫患者纳入本研究。使用形态分析程序（MAP）对T1加权体积MRI进行MRI后处理。回顾性分析了临床资料，包括症状学、MEG、头皮脑电图（EEG）、颅内EEG和手术策略。MAP阳性区域的相关性通过手术结果和病理证实。结果如下：在2010-2018年期间，共有20例诊断为岛叶盖癫痫的患者接受了非病灶MRI检查，其中11例患者接受了切除手术。MEG显示5例患者的额下区和5例患者的颞-岛/额-颞-岛/顶-岛区的单个等效电流偶极子（SECD）簇。11例患者中有4例MAP结果阳性。MAP阳性率为36.4%。阳性区域1例位于岛叶，3例位于岛盖区。4例MAP阳性患者中3例在成功切除MAP阳性和MEG阳性区域后获得无瘤生存（2例病理结果为FCD IIb，1例为FCD IIa）。结论：MAP对MRI阴性的岛叶癫痫患者的致痫灶有一定的诊断价值。值得注意的是，为了做出正确的手术方案决定，MAP结果应始终在患者的解剖-电临床表现的背景下进行解释。
Objective: The aim of this study was to use voxel-based MRI post-processing in detection of subtle FCD in drug-resistant operculoinsular epilepsy patients with negative presurgical MRI, and by combining magnetoencephalography (MEG) to improve the localization of epileptogenic zone. Methods: Operculoinsular epilepsy patients with a negative presurgical MRI were included in this study. MRI post-processing was performed using a Morphometric Analysis Program (MAP) on T1-weighted volumetric MRI. Clinical information including semiology, MEG, scalp electroencephalogram (EEG), intracranial EEG and surgical strategy was retrospectively reviewed. The pertinence of MAP-positive areas was confirmed by surgical outcome and pathology. Results: A total of 20 patients were diagnosed with operculoinsular epilepsy had non-lesional MRI during 2010–2018, of which 11 patients with resective surgeries were included. MEG showed clusters of single equivalent current dipole (SECD) in inferior frontal regions in five patients and temporal-insular/ frontal-temporal-insular/parietal-insular regions in five patients. Four out of 11 patients had positive MAP results. The MAP positive rate was 36.4%. The positive regions were in insular in one patient and operculoinsular regions in three patients. Three of the four patients who were MAP-positive got seizure-free after successfully resect the MAP-positive and MEG-positive regions (the pathology results were FCD IIb in two patients and FCD IIa in one patient). Conclusions: MAP is a useful tool in detection the epileptogenic lesions in patients with MRI-negative operculoinsular epilepsy. Notably, in order to make a right surgical regime decision, MAP results should always be interpreted in the context of the patient's anatomo-electroclinical presentation.
登录
查看更多内容
影响因子：
2
作者：
N. Geevasinga;J. Archer;K. Ng
通讯作者：
N. Geevasinga;J. Archer;K. Ng
DOI：
10.1016/j.nicl.2018.04.034
发表时间：
2018
期刊：
NeuroImage. Clinical
影响因子：
--
作者：
Kasper BS;Rössler K;Hamer HM;Dörfler A;Blümcke I;Coras R;Roesch J;Mennecke A;Wellmer J;Sommer B;Lorber B;Lang JD;Graf W;Stefan H;Schwab S;Buchfelder M;Rampp S
通讯作者：
Rampp S
影响因子：
5.6
作者：
Ryvlin, P;Minotti, L;Kahane, P
通讯作者：
Kahane, P
影响因子：
5.6
作者：
Laoprasert, Pramote;Ojemann, Jeffrey G.;Handler, Michael H.
通讯作者：
Handler, Michael H.
影响因子：
14.5
作者：
Wagner, Jan;Weber, Bernd;Huppertz, Hans-Juergen
通讯作者：
Huppertz, Hans-Juergen