Multiple subpial transections and magnetic resonance imaging
| Autor: | K. van Rijckevorsel, G. Vaz, P. Finet, Cécile Grandin, C. Raftopoulos |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Drug Resistant Epilepsy Adolescent Postoperative mri Neurosurgical Procedures 030218 nuclear medicine & medical imaging Intraoperative MRI Young Adult 03 medical and health sciences 0302 clinical medicine Edema Cortex (anatomy) Humans Medicine Child Neuronavigation Retrospective Studies Cerebral Cortex medicine.diagnostic_test business.industry Infant Magnetic resonance imaging Epileptogenic zone Magnetic Resonance Imaging medicine.anatomical_structure Hemosiderin Pia Mater Female Surgery Electrocorticography Neurology (clinical) medicine.symptom business Nuclear medicine human activities Multiple subpial transection 030217 neurology & neurosurgery |
| Zdroj: | Neurochirurgie. 63:449-452 |
| ISSN: | 0028-3770 |
| DOI: | 10.1016/j.neuchi.2017.08.002 |
| Popis: | Introduction Multiple subpial transection (MST) has been applied to the treatment of refractory epilepsy when epileptogenic zone involves eloquent areas since 1989. However, there is a lack of data evaluating the effect of this surgical technique on the cortex as measured by Magnetic Resonance Imaging (MRI). Patients and methods Ten consecutive patients (3F/7 M, average age: 18.5 years) were operated on using radiating MST (average: 39; min: 19, max: 61) alone (n = 3) or associated with another technique (n = 7). Seven patients underwent a post-operative 3.0 T MRI while 3 had a 1.5 T MRI. Three patients had an early post-operative MRI and 7 a late MRI, among which 3 previously had an intraoperative MRI. Results The MR sequences that allowed the best assessment of MST-induced changes were T2 and T2*. The traces of MST are more visible on late MRI. These discrete non-complicated stigmas of MST were observed in all 10 studied patients: on the intraoperative MRI they are seen as micro-hemorrhagic spots (hypo-T2), on the early postoperative MRI as a discreet and limited cortical edema whether associated or not with micro-hemorrhagic spots and on the late MRI as liquid micro-cavities (hyper-T2) surrounded with a fine border of hemosiderin. Conclusions MST-induced cerebral lesions are best visualized in T2-sequences, mainly on the late postoperatively MRIs. On all the MRI examinations in this study, the MST are only associated with limited modifications of the treated cortical regions. |
| Databáze: | OpenAIRE |
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