Arterial Spin Labeling MRI: A step forward in non-invasive delineation of focal cortical dysplasia in children
Arterial Spin Labeling MRI: A step forward in non-invasive delineation of focal cortical dysplasia in children
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DOI：
10.1016/j.eplepsyres.2014.09.029
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发表时间：
2014-12-01
影响因子：
2.2
通讯作者：
Nabbout, Rima
中科院分区：
文献类型：
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作者：
Blauwblomme, Thomas;Boddaert, Nathalie;Nabbout, Rima
目的是在一项回顾性研究中，对9名连续儿童进行了发作间期多模式调查，采用动脉自旋标记MRI（ASL）定位儿童局灶性皮质发育不良（FCD）的发作间期脑灌注异常。我们用1.5T MRI和癫痫专用方案分析了脑形态。用伪连续ASL定量脑灌注。在6名患者中，使用（18）FDG-PET对脑代谢进行成像。对5名接受癫痫手术的儿童进行了微血管组织学研究，并对FCD和对照样本进行了CD 34免疫染色。所有ASL患者的视觉分析均发现局部脑血流量（CBF）减少。在每例病例中，它与结构性MRI异常共定位，在5/6例病例中PET代谢低下，在5/5例病例中组织学证实的FCD IIb型（术后均无癫痫发作）。FCD中的CBF低于正常皮质（Kruskal-Wallis检验，p = 0.001）。FCD和对照组的CD 34+微血管总数相似，但微血管结构紊乱。发作间期ASL是一种非侵入性方法，可帮助定位FCD中显示低灌注的致痫区。这一发现是否可以推广到MRI阴性的FCD需要进一步研究。(C)2014爱思唯尔有限公司版权所有。
The aim was to localize the interictal cerebral perfusion abnormalities of focal cortical dysplasia (FCD) in children with Arterial Spin Labeling MRI (ASL) in a retrospective study of nine consecutive children explored with multimodal investigation during interictal periods. We analyzed brain morphology with a 1.5T MRI and a dedicated protocol for epilepsy. Brain perfusion was quantified with pseudo continuous ASL. Brain metabolism was imaged with (18)FDG-PET in six patients. Microvessel histology was studied in five children who underwent epilepsy surgery with CD34 immunostaining on FCD and control samples. Localized decrease of cerebral blood flow (CBF) was found on visual analysis in all patients with ASL. It was co-localized with the structural MRI abnormalities in every case, with PET hypo-metabolism in 5/6 cases, and with histologically proven FCD type lib in 5/5 cases (all seizure free after surgery). CBF was lower (Kruskal-Wallis test, p = 0.001) in FCD than in normal cortex. The total count of CD34+ microvessels was similar in FCD and control cases, but microvasculature showed disorganized architecture. Interictal ASL is a non-invasive method that may help to localize the epileptogenic zone showing hypo-perfusion in FCD. Whether this finding could be generalized to MRI-negative FCD needs to be further studied. (C) 2014 Elsevier B.V. All rights reserved.