Preoperative Detection of Subtle Focal Cortical Dysplasia in Children by Combined Arterial Spin Labeling, Voxel-Based Morphometry, Electroencephalography-Synchronized Functional MRI, Resting-State Regional Homogeneity, and 18F-fluorodeoxyglucose Positron Emission Tomography

被引：7

作者：

Dangouloff-Ros, Volodia ^{[1
,2
,3
,11
]}

Fillon, Ludovic ^{[1
,2
,3
]}

Eisermann, Monika ^{[4
,5
]}

Losito, Emma ^{[5
,6
]}

Boisgontier, Jennifer ^{[1
,2
,3
]}

Charpy, Sarah ^{[1
,2
,3
]}

Saitovitch, Ana ^{[1
,2
,3
]}

Levy, Raphael ^{[1
,2
,3
]}

Roux, Charles-Joris ^{[1
,2
,3
]}

Varlet, Pascale ^{[7
]}

Chiron, Catherine ^{[6
,8
,9
]}

Bourgeois, Marie ^{[10
]}

Kaminska, Anna ^{[4
,5
]}

Blauwblomme, Thomas ^{[5
,10
]}

Nabbout, Rima ^{[5
,6
]}

Boddaert, Nathalie ^{[1
,2
,3
]}

机构：

[1] Hop Univ Necker Enfants Malad, AP HP, Pediatr Radiol Dept, Paris, France

[2] Univ Paris Cite, INSERM U1299, Paris, France

[3] Univ Paris Cite, Inst Imagine, UMR 1163, Paris, France

[4] Hop Univ Necker Enfants Malad, AP HP, Dept Clin Neurophysiol, Paris, France

[5] Univ Paris Cite, Inst Imagine, INSERM U 1163, Paris, France

[6] Hop Univ Necker Enfants Malad, AP HP, Reference Ctr Rare Epilepsies, Pediat Neurol Dept, Paris, France

[7] Univ Paris Cite, GHU Paris, Neuropathol Dept, Paris, France

[8] SHFJ CEA, Dept Nucl Med, Orsay, France

[9] INSERM U1141, Paris, France

[10] Hop Univ Necker Enfants Malad, AP HP, Pediat Neurosurg Dept, Paris, France

[11] Hop Univ Necker Enfants Malades, Assistance Publ Hop Paris, Dept Pediat Radiol, 149 rue Sevres, F-75015 Paris, France

来源：

NEUROSURGERY | 2023年 / 92卷 / 04期

关键词：

Children; Epilepsy; Functional MRI; Malformation of cortical development; Seizures; EEG SOURCE ANALYSIS; EPILEPSY; FMRI;

D O I：

10.1227/neu.0000000000002310

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

BACKGROUND:Focal cortical dysplasia (FCD) causes drug-resistant epilepsy in children that can be cured surgically, but the lesions are often unseen by imaging.OBJECTIVE:To assess the efficiency of arterial spin labeling (ASL), voxel-based-morphometry (VBM), fMRI electroencephalography (EEG), resting-state regional homogeneity (ReHo), 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET), and their combination in detecting pediatric FCD.METHODS:We prospectively included 10 children for whom FCD was localized by surgical resection. They underwent 3T MR acquisition with concurrent EEG, including ASL perfusion, resting-state BOLD fMRI (allowing the processing of EEG-fMRI and ReHo), 3D T1-weighted images processed using VBM, and FDG PET-CT coregistered with MRI. Detection was assessed visually and by comparison with healthy controls (for ASL and VBM).RESULTS:Eight children had normal MRI, and 2 had asymmetric sulci. Using MR techniques, FCD was accurately detected by ASL for 6/10, VBM for 5/10, EEG-fMRI for 5/8 (excluding 2 with uninterpretable results), and ReHo for 4/10 patients. The combination of ASL, VBM, and ReHo allowed correct FCD detection for 9/10 patients. FDG PET alone showed higher accuracy than the other techniques (7/9), and its combination with VBM allowed correct FCD detection for 8/9 patients. The detection efficiency was better for patients with asymmetric sulci (2/2 for all techniques), but advanced MR techniques and PET were useful for MR-negative patients (7/8).CONCLUSION:A combination of multiple imaging techniques, including PET, ASL, and VBM analysis of T1-weighted images, is effective in detecting subtle FCD in children.

引用

页码：820 / 826

页数：7