3D高分辨MRI在局灶性皮质发育不良Ⅱ型患儿中的应用
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摘要
目的探讨3D高分辨MR成像在儿童局灶性皮质发育不良(FCD)Ⅱ型中的应用价值。方法回顾性分析18例经病理证实的FCDⅡ型患儿的MRI资料,观察灰白质分界模糊、局灶性皮质结构异常、灰白质信号以及transmantle征(皮层下白质内向脑室方向延伸的异常信号)等征象,计算并比较各序列对以上征象的检出率。结果 18例患儿中,15例存在MRI阳性征象,包括灰白质分界模糊14例(14/18,77.78%),局灶性皮质结构异常11例(11/18,61.11%),transmantle征10例(10/18,55.56%),白质信号异常11例(11/18,61.11%)及灰质信号异常13例(13/18,72.22%)。3DT1WI对灰白质分界模糊、局灶性皮质结构异常、白质信号异常和灰质信号异常的检出率均高于常规T1WI(P=0.009、0.022、0.038、0.020);3D-T2FLAIR对灰白质分界模糊、局灶性皮质结构异常和灰质信号异常检出率高于T2FLAIR序列(P=0.022、0.018、0.009)。结论 3D高分辨MR序列可提高对FCDⅡ型患儿的检出率,为术前评估提供更准确的信息。
Objective To observe the application value of 3 Dhigh-resolution MRI in children with focal cortical dysplasia(FCD)of typeⅡ.Methods MRI data of 18 children with FCD Ⅱconfirmed by pathology were retrospectively analyzed.The following MRI signs,including blurring of junction of the gray matter-white matter,abnormality of structure with focal cortex,gray matter and white matter signal,transmantle sign(the abnormal signal extending to the ventricle in subcortical white matter)were observed.Then the detection rates of the above MRI signs in each sequence were calculated and compared.Results In all of the 18 children,MRI abnormities were found in 15 children,including blurring of junction of the gray-white matter in 14(14/18,77.78%),the abnormality of structure with focal cortex in 11(11/18,61.11%),transmantle sign in 10(10/18,55.56%),the abnormality of white matter signal in 11(11/18,61.11%)and the abnormality of gray matter signal in 13(13/18,72.22%).The detection rates of 3 D-T1 WI were higher than those of T1 WI for blurring of junction of the gray-white matter,abnormality of structure with focal cortex,the abnormality of white matter signal and the abnormality of gray matter signal(P=0.009,0.022,0.038,0.020).The detection rates of3 D-T2 FLAIR were higher than those of T2 FLAIR sequence for the blurring of junction of the gray-white matter,abnormality of structure with focal cortex and the abnormality of gray matter signal(P =0.022,0.018,0.009).Conclusion 3 D high-resolution MR sequences could improve the detection rate of FCD Ⅱ,therefore providing more accurate information for preoperative assessment.
Objective To observe the application value of 3 Dhigh-resolution MRI in children with focal cortical dysplasia(FCD)of typeⅡ.Methods MRI data of 18 children with FCD Ⅱconfirmed by pathology were retrospectively analyzed.The following MRI signs,including blurring of junction of the gray matter-white matter,abnormality of structure with focal cortex,gray matter and white matter signal,transmantle sign(the abnormal signal extending to the ventricle in subcortical white matter)were observed.Then the detection rates of the above MRI signs in each sequence were calculated and compared.Results In all of the 18 children,MRI abnormities were found in 15 children,including blurring of junction of the gray-white matter in 14(14/18,77.78%),the abnormality of structure with focal cortex in 11(11/18,61.11%),transmantle sign in 10(10/18,55.56%),the abnormality of white matter signal in 11(11/18,61.11%)and the abnormality of gray matter signal in 13(13/18,72.22%).The detection rates of 3 D-T1 WI were higher than those of T1 WI for blurring of junction of the gray-white matter,abnormality of structure with focal cortex,the abnormality of white matter signal and the abnormality of gray matter signal(P=0.009,0.022,0.038,0.020).The detection rates of3 D-T2 FLAIR were higher than those of T2 FLAIR sequence for the blurring of junction of the gray-white matter,abnormality of structure with focal cortex and the abnormality of gray matter signal(P =0.022,0.018,0.009).Conclusion 3 D high-resolution MR sequences could improve the detection rate of FCD Ⅱ,therefore providing more accurate information for preoperative assessment.
引文
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[9]秦耿耿,代月黎,陈卫国,等.基于纤维束的空间统计方式的复发缓解型多发性硬化患者磁共振扩散张量成像与正常人对照.中国医学物理学杂志,2016,33(8):799-804.
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[12]Wang ZI,Alexopoulos AV,Jones SE,et al.Linking MRIpostprocessing with magnetic source imaging in MRI-negative epilepsy.Ann Neurol,2014,75(5):759-770.
[2]Blümcke I,Thom M,Aronica E,et al.The clinicopathologic spectrum of focal cortical dysplasias:A consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission.Epilepsia,2011,52(1):158-174.
[3]Foldvary-Schaefer N,Bautista J,Andermann F,et al.Focal malformations of cortical development.Neurology,2004,62(6Suppl 3):14-19.
[4]程彦昊,蔡立新,李坤成,等.局灶性脑皮质发育不良病理分型的MRI特点.中华放射学杂志,2007,41(5):493-495.
[5]Krsek P,Pieper T,Karlmeier A,et al.Different presurgical characteristics and seizure outcomes in children with focal cortical dysplasia typeⅠorⅡ.Epilepsia,2009,50(1):125-137.
[6]Colombo N,Tassi L,Deleo F,et al.Focal cortical dysplasia typeⅡa andⅡb:MRI aspects in 118cases proven by histopathology.Neuroradiology,2012,54(10):1065-1077.
[7]Zucca I,Milesi G,Medici V,et al.TypeⅡfocal cortical dysplasia:Ex vivo 7T magnetic resonance imaging abnormalities and histopathological comparisons.Ann Neurol,2016,79(1):42-58.
[8]阮志兵,焦俊,闵定玉,等.结节性硬化综合症的CT与MRI表现.临床放射学杂志,2015,34(10):1560-1565.
[9]秦耿耿,代月黎,陈卫国,等.基于纤维束的空间统计方式的复发缓解型多发性硬化患者磁共振扩散张量成像与正常人对照.中国医学物理学杂志,2016,33(8):799-804.
[10]Dahnke R,Yotter RA,Gaser C.Cortical thickness and central surface estimation.Neuroimage,2013,65:336-348.
[11]桑林,张凯,张建国,等.PET-MRI影像融合技术在药物难治性癫痫术前评估中的价值.中华神经外科杂志,2017,33(6):559-563.
[12]Wang ZI,Alexopoulos AV,Jones SE,et al.Linking MRIpostprocessing with magnetic source imaging in MRI-negative epilepsy.Ann Neurol,2014,75(5):759-770.