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De Ciantis A, Barkovich AJ, Cosottini M, Barba C, Montanaro D, Costagli M, Tosetti M, Biagi L, Dobyns WB, Guerrini R. Ultra-high-field MR imaging in polymicrogyria and epilepsy. AJNR Am J Neuroradiol 2014; 36:309-16. [PMID: 25258368 DOI: 10.3174/ajnr.a4116] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Polymicrogyria is a malformation of cortical development that is often identified in children with epilepsy or delayed development. We investigated in vivo the potential of 7T imaging in characterizing polymicrogyria to determine whether additional features could be identified. MATERIALS AND METHODS Ten adult patients with polymicrogyria previously diagnosed by using 3T MR imaging underwent additional imaging at 7T. We assessed polymicrogyria according to topographic pattern, extent, symmetry, and morphology. Additional imaging sequences at 7T included 3D T2* susceptibility-weighted angiography and 2D tissue border enhancement FSE inversion recovery. Minimum intensity projections were used to assess the potential of the susceptibility-weighted angiography sequence for depiction of cerebral veins. RESULTS At 7T, we observed perisylvian polymicrogyria that was bilateral in 6 patients, unilateral in 3, and diffuse in 1. Four of the 6 bilateral abnormalities had been considered unilateral at 3T. While 3T imaging revealed 2 morphologic categories (coarse, delicate), 7T susceptibility-weighted angiography images disclosed a uniform ribbonlike pattern. Susceptibility-weighted angiography revealed numerous dilated superficial veins in all polymicrogyric areas. Tissue border enhancement imaging depicted a hypointense line corresponding to the gray-white interface, providing a high definition of the borders and, thereby, improving detection of the polymicrogyric cortex. CONCLUSIONS 7T imaging reveals more anatomic details of polymicrogyria compared with 3T conventional sequences, with potential implications for diagnosis, genetic studies, and surgical treatment of associated epilepsy. Abnormalities of cortical veins may suggest a role for vascular dysgenesis in pathogenesis.
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Affiliation(s)
- A De Ciantis
- From the Pediatric Neurology Unit (A.D.C., C.B., R.G.), Meyer Children's Hospital, University of Florence, Florence, Italy
| | - A J Barkovich
- Department of Radiology and Biomedical Imaging (A.J.B.), University of California San Francisco, San Francisco, California
| | - M Cosottini
- Department of Translational Research and New Technologies in Medicine and Surgery (M. Cosottini), University of Pisa, Pisa, Italy IMAGO7 Foundation (M. Cosottini), Pisa, Italy
| | - C Barba
- From the Pediatric Neurology Unit (A.D.C., C.B., R.G.), Meyer Children's Hospital, University of Florence, Florence, Italy
| | - D Montanaro
- Fondazione Consiglio Nazionale delle Ricerche/Regione Toscana (D.M.), Unità Operativa Semplice Neuroradiologia, Pisa, Italy
| | - M Costagli
- Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (M. Costagli, M.T., L.B., R.G.), Pisa, Italy
| | - M Tosetti
- Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (M. Costagli, M.T., L.B., R.G.), Pisa, Italy
| | - L Biagi
- Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (M. Costagli, M.T., L.B., R.G.), Pisa, Italy
| | - W B Dobyns
- Center for Integrative Brain Research (W.B.D.), Seattle Children's Hospital, Seattle, Washington
| | - R Guerrini
- From the Pediatric Neurology Unit (A.D.C., C.B., R.G.), Meyer Children's Hospital, University of Florence, Florence, Italy Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (M. Costagli, M.T., L.B., R.G.), Pisa, Italy
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Barba C, Giovannelli F, Frija F, Borgheresi A, De Ciantis A, Montanaro D, Cincotta M, Guerrini R. S2.5 An integrated multimodal approach for assessing functional reorganization in unilateral polymicrogyria. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60012-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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