Small focal cortical dysplasia lesions are located at the bottom of a deep sulcus
Small focal cortical dysplasia lesions are located at the bottom of a deep sulcus
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DOI：
10.1093/brain/awn224
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发表时间：
2008-12-01
期刊：
影响因子：
14.5
通讯作者：
Bernasconi, Andrea
中科院分区：
文献类型：
--
作者：
Besson, Pierre;Andermann, Frederick;Bernasconi, Andrea
局灶性皮质发育不良（FCD）的特点是轻微的结构变化，可能无法识别的标准放射分析。由于脑回的复杂性，视觉评估FCD的形态学特征和包含它们的脑沟是困难的。我们的目的是阐明和量化的FCD病变和脑沟之间的空间关系，使用自动化的脑沟提取和形态测量。我们使用高分辨率MRI研究了43例连续FCD患者。使用定性（常规MRI的初始临床评估检测）和定量（体积）标准将病变分为小病变和大病变。使用基于神经网络集合的算法自动识别和标记脑沟。然后在3D中同时可视化分段FCD病变和脑沟。我们测量了21名健康对照者与每个FCD相关的脑沟和相应脑沟的平均和最大深度。此外，我们还计算了FCD附近的脑沟深度。21例（21/43 49）患者有小FCD病变（体积范围：1283093 mm（3））。其中，17（81）例在初始放射学评价期间被忽略，随后使用图像处理进行了识别。18个（18/2186）小FCD病灶位于沟底。另外两个与两个脑沟的壁有关，一个位于脑回的冠部。与FCD相关的脑沟的平均和最大深度高于对照组中相应脑沟的平均和最大深度（P 0.008）。病变邻近区域内的沟深度平均值大于整个沟的深度（P 0.0002）。小FCD病变优先位于异常深沟底部的证据可用于指导发育异常的搜索，特别是在大尺度MRI特征仅轻度异常或不存在的患者中。
Focal cortical dysplasia (FCD) is often characterized by minor structural changes that may go unrecognized by standard radiological analysis. Visual assessment of morphological characteristics of FCD and sulci harbouring them is difficult due to the complexity of brain convolutions. Our purpose was to elucidate and quantify the spatial relationship between FCD lesions and brain sulci using automated sulcal extraction and morphometry. We studied 43 consecutive FCD patients using high-resolution MRI. Lesions were classified into small and large using qualitative (detection on initial clinical assessment of conventional MRI) and quantitative (volume) criteria. Sulci were identified and labelled automatically using an algorithm based on a congregation of neural networks. Segmented FCD lesions and sulci were then simultaneously visualized in 3D. We measured mean and maximum depth of sulci related to each FCD and of the corresponding sulci in 21 healthy controls. In addition, we calculated sulcal depth within the FCD neighbourhood. Twenty-one (21/43 49) patients had small FCD lesions (volume range: 1283093 mm(3)). Among them, 17 (81) had been overlooked during initial radiological evaluation and were subsequently identified using image processing. Eighteen (18/21 86) small FCD lesions were located at the bottom of a sulcus. Two others were related to the walls of two sulci and one was located at the crown of a gyrus. Mean and maximum depth of sulci related to the FCD was higher than that of the corresponding sulci in controls (P 0.008). Sulcal depth within lesional neighbourhood had larger mean depth than that of the entire sulcus (P 0.0002). Evidence that small FCD lesions are preferentially located at the bottom of an abnormally deep sulcus may be used to direct the search for developmental abnormalities, particularly in patients in whom large-scale MRI features are only mildly abnormal or absent.