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Structural association between heterotopia and cortical lesions visualized with 7T MRI in patients with focal epilepsy

Zampeli, Ariadne LU ; Hansson, Boel LU ; Markenroth Bloch, Karin LU orcid ; Englund, Elisabet LU orcid ; Källén, Kristina LU ; COMPAGNO STRANDBERG, MARIA LU and Björkman-Burtscher, Isabella LU (2022) In Seizure 101. p.177-183
Abstract
Purpose
To analyse structural characteristics of malformations of cortical development (MCD) at 7T and 3T MRI.
Methods
Twenty-five patients were examined with a 7T MRI-scanner in addition to 3T examinations performed for epilepsy evaluation. 7T sequences included a 3D-T1-weighted (T1w) MPRAGE, 3D-T2w FLAIR, and heavily T2w axial and coronal high-resolution (0.5×0.5×0.75-1.0 mm3) 2D-TSE sequences. Images were reviewed for 7T MRI imaging characteristics of MCD, visibility and frequency of identified lesions on 7T and on 3T (original reports and second reading).
Results
In 25 patients 112 lesions were identified (57 gray matter (GM) heterotopia, 37 focal cortical dysplasia (FCD), and 18 other MCD). Imaging characteristics... (More)
Purpose
To analyse structural characteristics of malformations of cortical development (MCD) at 7T and 3T MRI.
Methods
Twenty-five patients were examined with a 7T MRI-scanner in addition to 3T examinations performed for epilepsy evaluation. 7T sequences included a 3D-T1-weighted (T1w) MPRAGE, 3D-T2w FLAIR, and heavily T2w axial and coronal high-resolution (0.5×0.5×0.75-1.0 mm3) 2D-TSE sequences. Images were reviewed for 7T MRI imaging characteristics of MCD, visibility and frequency of identified lesions on 7T and on 3T (original reports and second reading).
Results
In 25 patients 112 lesions were identified (57 gray matter (GM) heterotopia, 37 focal cortical dysplasia (FCD), and 18 other MCD). Imaging characteristics of the 37 FCD were cortical thickening (n=11); GM-WM border blurring (n=30); GM signal intensity changes (n=18); juxtacortical WM signal intensity changes (n=18); and transmantle WM signal intensity changes (n=11). None of the 7T MRI sequences was sufficient to detect all types of lesions. Heterotopia were in general isointense to normal GM. Structural associations between 36 heterotopia and overlaying cortex were observed, composed either of a direct connection, vessel-like structures, or GM-like bridges.
FCD were mentioned in 30% (11 of 37) of the original reports at 3T, and in 57% (21 of 37) after second reading. FCD connections to subcortical heterotopia were clinically not reported at all.
Conclusion
7T MRI revealed subtle connections between heterotopia and previous unidentified pathology in overlaying cortex. These findings may be significant for the understanding of the anatomical seizure origin and propagation pathways. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Seizure
volume
101
pages
7 pages
publisher
Elsevier
external identifiers
  • scopus:85137047042
  • pmid:36058100
ISSN
1532-2688
DOI
10.1016/j.seizure.2022.08.008
language
English
LU publication?
yes
id
43670b39-d375-4a03-a0e0-5e01d3d1bc1e
date added to LUP
2022-08-28 07:46:57
date last changed
2023-05-15 09:41:09
@article{43670b39-d375-4a03-a0e0-5e01d3d1bc1e,
  abstract     = {{Purpose<br/>To analyse structural characteristics of malformations of cortical development (MCD) at 7T and 3T MRI.<br/>Methods<br/>Twenty-five patients were examined with a 7T MRI-scanner in addition to 3T examinations performed for epilepsy evaluation. 7T sequences included a 3D-T1-weighted (T1w) MPRAGE, 3D-T2w FLAIR, and heavily T2w axial and coronal high-resolution (0.5×0.5×0.75-1.0 mm3) 2D-TSE sequences. Images were reviewed for 7T MRI imaging characteristics of MCD, visibility and frequency of identified lesions on 7T and on 3T (original reports and second reading).<br/>Results<br/>In 25 patients 112 lesions were identified (57 gray matter (GM) heterotopia, 37 focal cortical dysplasia (FCD), and 18 other MCD). Imaging characteristics of the 37 FCD were cortical thickening (n=11); GM-WM border blurring (n=30); GM signal intensity changes (n=18); juxtacortical WM signal intensity changes (n=18); and transmantle WM signal intensity changes (n=11). None of the 7T MRI sequences was sufficient to detect all types of lesions. Heterotopia were in general isointense to normal GM. Structural associations between 36 heterotopia and overlaying cortex were observed, composed either of a direct connection, vessel-like structures, or GM-like bridges.<br/>FCD were mentioned in 30% (11 of 37) of the original reports at 3T, and in 57% (21 of 37) after second reading. FCD connections to subcortical heterotopia were clinically not reported at all.<br/>Conclusion<br/>7T MRI revealed subtle connections between heterotopia and previous unidentified pathology in overlaying cortex. These findings may be significant for the understanding of the anatomical seizure origin and propagation pathways.}},
  author       = {{Zampeli, Ariadne and Hansson, Boel and Markenroth Bloch, Karin and Englund, Elisabet and Källén, Kristina and COMPAGNO STRANDBERG, MARIA and Björkman-Burtscher, Isabella}},
  issn         = {{1532-2688}},
  language     = {{eng}},
  month        = {{10}},
  pages        = {{177--183}},
  publisher    = {{Elsevier}},
  series       = {{Seizure}},
  title        = {{Structural association between heterotopia and cortical lesions visualized with 7T MRI in patients with focal epilepsy}},
  url          = {{http://dx.doi.org/10.1016/j.seizure.2022.08.008}},
  doi          = {{10.1016/j.seizure.2022.08.008}},
  volume       = {{101}},
  year         = {{2022}},
}