The value of high-resolution MRI in predicting the outcome of surgery for focal cortical dysplasia in children_Journal of Epilepsy

Authors：

LI Lin , CUI Ruodi , YANG Guangyong , MA Changyou ,  ZHAO Jianshe

The Center of Medical Imaging, Qilu Children's Hospital of Shandong University, Jinan 250022, China;

Corresponding author：

ZHAO Jianshe, Email: zhaojianshe@163.com

Keywords：

Children; Focal cortical dysplasia; Magnetic resonance imaging; Neurosurgical procedures; Prognosis

DOI：

10.7507/2096-0247.20210004

Video：

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Objective To explore the value of high-resolution Magnetic resonance imaging (MRI) imaging in predicting the surgical effect of Focal cortical dysplasia (FCD) in children.Methods The MRI and clinical data of 143 children with FCD confirmed by surgery and pathology in Qilu Children’s Hospital of Shandong University from July 2013 to July 2018 were analyzed retrospectively, and the MRI signs were analyzed, and the patients were grouped according to different signs to analyze the satisfaction of postoperative epilepsy control in each group.Results Among the 9 groups of children, MRI signs in the group with better postoperative epilepsy control were those with obvious focal gray matter blurring and cortical thickening and combined with Transmantle sign. The MRI signs in the group with poor postoperative results were mild focal gray matter blurring and cortical structure thinning, and those with abnormal sulcus and gyrus morphology, the postoperative effect of patients with only abnormal sulci and gyrus as the main MRI manifestations was significantly better than those with other signs, and the above differences were statistically significant (P<0.05).Conclusion The high-resolution MRI of children with FCD had a certain specificity, and it is feasible to predict the satisfaction of postoperative epilepsy control from the perspective of MRI signs, which is an important indicator of surgical prognosis.

Citation： LI Lin, CUI Ruodi, YANG Guangyong, MA Changyou, ZHAO Jianshe. The value of high-resolution MRI in predicting the outcome of surgery for focal cortical dysplasia in children. Journal of Epilepsy, 2021, 7(1): 29-33. doi: 10.7507/2096-0247.20210004 Copy

1.	Kakita A. Surgical pathologic features of cerebral cortical lesions taken from 600 patients with intractable epilepsy. Brain Dev, 2013, 35(8): 793-801.
2.	Jayalakshmi S, Nanda SK, Vooturi S, et al. Focal cortical dysplasia and refractory epilepsy: Role of multimodality imaging and outcome of surgery. AJNR J Neuroradiol, 2019, 40(5): 892-898.
3.	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.
4.	Ahmed R, Rubinger L, Go C, et al. Utility of additional dedicated high-resolution 3T MRI in children with medically refractory focal epilepsy. Epilepsy Res, 2018, 143(2018): 113-119.
5.	Veersema TJ, Ferrier CH, van Eijsden P, et al. Seven tesla MRI improves detection of focal cortical dysplasia in patients with refractory focal epilepsy. Epilepsia Open, 2017, 2(2): 162-171.
6.	Ma D, Jones SE, Deshmane A, et al. Development of high-resolution 3D MR fingerprinting for detection and characterization of epileptic lesions. J Magn Reson Imaging, 2019, 49(5): 1333-1346.
7.	Widjaja E, Otsubo H, Raybaud C, et al. Characteristics of MEG and MRI between Taylor's focal cortical dysplasia (type II) and other cortical dysplasia: surgical outcome after complete resection of MEG spike source and MR lesion in pediatric cortical dysplasi. Epilepsy Res, 2008, 82(2-3): 147-155.
8.	Jin B, Krishnan B, Adler S, et al. Automated detection of focal cortical dysplasia type II with surface-basedmagnetic resonance imaging postprocessing and machine learning. Epilepsia, 2018, 59(5): 982-992.
9.	Chen J, Chen X, Huang C, et al. Predictors of seizure recurrence in patients with surgery for focal cortical dysplasia: pairwise and network meta-analysis and trial sequential analysis. Childs Nerv Syst, 2019, 35(5): 753-767.
10.	Guye M, Bartolomei F, Ranjeva JP. Malformations of cortical development: The role of 7-Tesla magnetic resonance imaging in diagnosis. Rev Neurol(Paris), 2019, 175(3): 157-162.
11.	Hong SJ, Bernhardt BC, Caldairou B, et al. Multimodal MRI profiling of focal cortical dysplasia type II. Neurology, 2017, 88(8): 734-742.
12.	Taylor DC, Falconer MA, Bruton CJ, et al. Focal dysplasia of the cerebral cortex in epilepsy. J Neurol Neurosurg Psychiatry, 1971, 34(4): 369-387.
13.	Jin B, Wang J, Zhou J, et a1. A longitudinal study of surgical outcome of pharmacoresistat epilepsy caused by focal cortical dysplasia. J Neurol, 2016, 263(12): 2403-2410.
14.	Chern JJ, Patel AJ, Jea A, et a1. Surgical outcome for focal cortical dysplasia: an analysis of recent surgical series. A review. J Neurosurg Pediatr, 2010, 6(5): 452-458.
15.	Tassi L, Garbelli R, Colombo N, et al. Electroclinical, MRI and surgical outcomes in 100 epileptic patients with type II FCD. Epileptic Disord, 2012, 14(3): 257-266.
16.	Bourdillon P, Rheims S, Catenoix H, et al. Malformations of cortical development: New surgical advances. Rev Neurol (Paris), 2019, 175(3): 183-188.
17.	Kwon HE, Eom S, Kang HC, et a1. Surgical treatment of pediatric focal cortical dysplasia: Clinical spectrum and surgical outcome. Neurology, 2016, 87(9): 945-951.
18.	Colombo N, Tassi L, Deleo F, et al. Focal cortical dysplasia type Ⅱa and Ⅱb: MRI aspects in 118 cases proven by histopathology. Neuroradiology, 2012, 54(10): 1065-1077.
19.	Chassoux F, Landré E, Mellerio C, et al. Type II focal cortical dysplasia: electroclinical phenotype and surgical outcomerelated to imaging. Epilepsia, 2012, 53(2): 349-358.

1. Kakita A. Surgical pathologic features of cerebral cortical lesions taken from 600 patients with intractable epilepsy. Brain Dev, 2013, 35(8): 793-801.
2. Jayalakshmi S, Nanda SK, Vooturi S, et al. Focal cortical dysplasia and refractory epilepsy: Role of multimodality imaging and outcome of surgery. AJNR J Neuroradiol, 2019, 40(5): 892-898.
3. 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.
4. Ahmed R, Rubinger L, Go C, et al. Utility of additional dedicated high-resolution 3T MRI in children with medically refractory focal epilepsy. Epilepsy Res, 2018, 143(2018): 113-119.
5. Veersema TJ, Ferrier CH, van Eijsden P, et al. Seven tesla MRI improves detection of focal cortical dysplasia in patients with refractory focal epilepsy. Epilepsia Open, 2017, 2(2): 162-171.
6. Ma D, Jones SE, Deshmane A, et al. Development of high-resolution 3D MR fingerprinting for detection and characterization of epileptic lesions. J Magn Reson Imaging, 2019, 49(5): 1333-1346.
7. Widjaja E, Otsubo H, Raybaud C, et al. Characteristics of MEG and MRI between Taylor's focal cortical dysplasia (type II) and other cortical dysplasia: surgical outcome after complete resection of MEG spike source and MR lesion in pediatric cortical dysplasi. Epilepsy Res, 2008, 82(2-3): 147-155.
8. Jin B, Krishnan B, Adler S, et al. Automated detection of focal cortical dysplasia type II with surface-basedmagnetic resonance imaging postprocessing and machine learning. Epilepsia, 2018, 59(5): 982-992.
9. Chen J, Chen X, Huang C, et al. Predictors of seizure recurrence in patients with surgery for focal cortical dysplasia: pairwise and network meta-analysis and trial sequential analysis. Childs Nerv Syst, 2019, 35(5): 753-767.
10. Guye M, Bartolomei F, Ranjeva JP. Malformations of cortical development: The role of 7-Tesla magnetic resonance imaging in diagnosis. Rev Neurol(Paris), 2019, 175(3): 157-162.
11. Hong SJ, Bernhardt BC, Caldairou B, et al. Multimodal MRI profiling of focal cortical dysplasia type II. Neurology, 2017, 88(8): 734-742.
12. Taylor DC, Falconer MA, Bruton CJ, et al. Focal dysplasia of the cerebral cortex in epilepsy. J Neurol Neurosurg Psychiatry, 1971, 34(4): 369-387.
13. Jin B, Wang J, Zhou J, et a1. A longitudinal study of surgical outcome of pharmacoresistat epilepsy caused by focal cortical dysplasia. J Neurol, 2016, 263(12): 2403-2410.
14. Chern JJ, Patel AJ, Jea A, et a1. Surgical outcome for focal cortical dysplasia: an analysis of recent surgical series. A review. J Neurosurg Pediatr, 2010, 6(5): 452-458.
15. Tassi L, Garbelli R, Colombo N, et al. Electroclinical, MRI and surgical outcomes in 100 epileptic patients with type II FCD. Epileptic Disord, 2012, 14(3): 257-266.
16. Bourdillon P, Rheims S, Catenoix H, et al. Malformations of cortical development: New surgical advances. Rev Neurol (Paris), 2019, 175(3): 183-188.
17. Kwon HE, Eom S, Kang HC, et a1. Surgical treatment of pediatric focal cortical dysplasia: Clinical spectrum and surgical outcome. Neurology, 2016, 87(9): 945-951.
18. Colombo N, Tassi L, Deleo F, et al. Focal cortical dysplasia type Ⅱa and Ⅱb: MRI aspects in 118 cases proven by histopathology. Neuroradiology, 2012, 54(10): 1065-1077.
19. Chassoux F, Landré E, Mellerio C, et al. Type II focal cortical dysplasia: electroclinical phenotype and surgical outcomerelated to imaging. Epilepsia, 2012, 53(2): 349-358.

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