Focal cortical dysplasia type IIa and IIb: MRI aspects in 118 cases proven by histopathology
Focal cortical dysplasia type IIa and IIb: MRI aspects in 118 cases proven by histopathology
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DOI：
10.1007/s00234-012-1049-1
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发表时间：
2012-10-01
期刊：
影响因子：
2.8
通讯作者：
Spreafico, Roberto
中科院分区：
文献类型：
--
作者：
Colombo, Nadia;Tassi, Laura;Spreafico, Roberto
本研究旨在回顾大量局灶性皮质发育不良II型（FCD II）患者的磁共振成像（MRI）方面，并试图确定两种组织病理学亚型IIa和IIb的独特特征。我们回顾性回顾了118例经组织学证实为FCD IIa （n = 37）或IIb （n = 81）的顽固性癫痫手术治疗患者的MRI扫描。MRI异常93例（79%），无异常25例（21%）。90例（97%）发现发育不良病变，83例为FCD II型，7例为FCD非II型。3例MRI诊断为非FCD。皮层增厚（p = 0.002）和“transmantle征象”（p < 0.001）与FCD II的正确MRI诊断之间存在显著关联。FCD IIb型患者MRI阳性比FCD IIa型患者多（91%比51%），IIb型患者FCD II检出率也较好（88%比32%）。在IIb亚组中，transmantle征象明显更频繁（p = 0.003）。在IIb亚组中，FCD II的MRI异常结果和MRI正确诊断率显著高于IIb亚组。虽然其他MRI污点可能有助于诊断，但唯一有意义的相关性是transmantle征象和FCD IIb之间。
This study aims to review the magnetic resonance imaging (MRI) aspects of a large series of patients with focal cortical dysplasia type II (FCD II) and attempt to identify distinctive features in the two histopathological subtypes IIa and IIb.We retrospectively reviewed the MRI scans of 118 patients with histological proven FCD IIa (n = 37) or IIb (n = 81) who were surgically treated for intractable epilepsy.MRI was abnormal in 93 patients (79 %) and unremarkable in 25 (21 %). A dysplastic lesion was identified in 90 cases (97 %) and classified as FCD II in 83 and FCD non-II in seven cases. In three cases, the MRI diagnosis was other than FCD. There was a significant association between the presence of cortical thickening (p = 0.002) and the "transmantle sign" (p < 0.001) and a correct MRI diagnosis of FCD II. MRI positivity was more frequent in the patients with FCD IIb than in those with FCD IIa (91 % vs. 51 %), and the detection rate of FCD II was also better in the patients with type IIb (88 % vs. 32 %). The transmantle sign was significantly more frequent in the IIb subgroup (p = 0.003).The rates of abnormal MRI results and correct MRI diagnoses of FCD II were significantly higher in the IIb subgroup. Although other MRI stigmata may contribute to the diagnosis, the only significant correlation was between the transmantle sign and FCD IIb.