ObjectiveTo explore the value of high-resolution Magnetic resonance imaging (MRI) imaging in predicting the surgical effect of Focal cortical dysplasia (FCD) in children.MethodsThe 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.ResultsAmong 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).ConclusionThe 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.
Objective Discussed the postoperative seizure control situation of children with focal cortical dysplasia (FCD),which took Transmantle sign (T2WI or T2 FLAIR sequence inward extension cone high signal in the direction of ventricle) as the main MRI performance, and analyzed the influence of various factors on the prognosis of surgery.MethodsRetrospective analysis was performed on 56 children with FCD with Transmantle signs as the main MRI signs confirmed by pathology in Qilu Children's Hospital of Shandong University from May 2015 to March 2020, including 33 males and 23 females, with an average age of (4.8±0.13) years old, and their imaging and clinical data were analyzed. Analyzed the pathological types and main MRI signs, the range of epileptiform discharge, and Engel classification after surgery. Analyzed the effect of surgical method, type of onset, age of operation, epileptic site, course of disease and perioperative epileptic seizure on the surgical prognosis of children.ResultsPostoperative pathology showed that all the 56 cases both were FCDⅡb, in addition to the Transmantle sign, the MRI performance were also accompanied by focal blurring of gray and white matter, abnormal cortical structure, and abnormal signal foci in gray and white matter. Intraoperative EEG monitoring results showed that the epileptiform discharge area in all cases was larger than the lesion range showed by MRI. Postoperative Engel classification: 25 cases of gradeⅠ (43.8%), 18 cases of gradeⅡ (31.3%), 4 case of gradeⅢ (6.3%), 9 cases of gradeⅣ (18.8%). Surgical resection and perioperative seizures are independent factors affecting the prognosis of children (P<0.05).Conclusionsurgical methods and perioperative seizures were closely related to the prognosis of children.