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Research ArticleBrain
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Ultra-High-Field MR Imaging in Polymicrogyria and Epilepsy

A. De Ciantis, A.J. Barkovich, M. Cosottini, C. Barba, D. Montanaro, M. Costagli, M. Tosetti, L. Biagi, W.B. Dobyns and R. Guerrini
American Journal of Neuroradiology February 2015, 36 (2) 309-316; DOI: https://doi.org/10.3174/ajnr.A4116
A. De Ciantis
aFrom the Pediatric Neurology Unit (A.D.C., C.B., R.G.), Meyer Children's Hospital, University of Florence, Florence, Italy
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A.J. Barkovich
bDepartment of Radiology and Biomedical Imaging (A.J.B.), University of California San Francisco, San Francisco, California
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M. Cosottini
cDepartment of Translational Research and New Technologies in Medicine and Surgery (M. Cosottini), University of Pisa, Pisa, Italy
dIMAGO7 Foundation (M. Cosottini), Pisa, Italy
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C. Barba
aFrom the Pediatric Neurology Unit (A.D.C., C.B., R.G.), Meyer Children's Hospital, University of Florence, Florence, Italy
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D. Montanaro
eFondazione Consiglio Nazionale delle Ricerche/Regione Toscana (D.M.), Unità Operativa Semplice Neuroradiologia, Pisa, Italy
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M. Costagli
fIstituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (M. Costagli, M.T., L.B., R.G.), Pisa, Italy
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M. Tosetti
fIstituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (M. Costagli, M.T., L.B., R.G.), Pisa, Italy
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L. Biagi
fIstituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (M. Costagli, M.T., L.B., R.G.), Pisa, Italy
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W.B. Dobyns
gCenter for Integrative Brain Research (W.B.D.), Seattle Children's Hospital, Seattle, Washington.
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R. Guerrini
aFrom the Pediatric Neurology Unit (A.D.C., C.B., R.G.), Meyer Children's Hospital, University of Florence, Florence, Italy
fIstituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (M. Costagli, M.T., L.B., R.G.), Pisa, Italy
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Abstract

BACKGROUND AND PURPOSE: Polymicrogyria is a malformation of cortical development that is often identified in children with epilepsy or delayed development. We investigated in vivo the potential of 7T imaging in characterizing polymicrogyria to determine whether additional features could be identified.

MATERIALS AND METHODS: Ten adult patients with polymicrogyria previously diagnosed by using 3T MR imaging underwent additional imaging at 7T. We assessed polymicrogyria according to topographic pattern, extent, symmetry, and morphology. Additional imaging sequences at 7T included 3D T2* susceptibility-weighted angiography and 2D tissue border enhancement FSE inversion recovery. Minimum intensity projections were used to assess the potential of the susceptibility-weighted angiography sequence for depiction of cerebral veins.

RESULTS: At 7T, we observed perisylvian polymicrogyria that was bilateral in 6 patients, unilateral in 3, and diffuse in 1. Four of the 6 bilateral abnormalities had been considered unilateral at 3T. While 3T imaging revealed 2 morphologic categories (coarse, delicate), 7T susceptibility-weighted angiography images disclosed a uniform ribbonlike pattern. Susceptibility-weighted angiography revealed numerous dilated superficial veins in all polymicrogyric areas. Tissue border enhancement imaging depicted a hypointense line corresponding to the gray-white interface, providing a high definition of the borders and, thereby, improving detection of the polymicrogyric cortex.

CONCLUSIONS: 7T imaging reveals more anatomic details of polymicrogyria compared with 3T conventional sequences, with potential implications for diagnosis, genetic studies, and surgical treatment of associated epilepsy. Abnormalities of cortical veins may suggest a role for vascular dysgenesis in pathogenesis.

ABBREVIATIONS:

FSPGR
fast-spoiled gradient echo
GRE
gradient-recalled echo
IR
inversion recovery
SWAN
susceptibility-weighted angiography
TBE
tissue border enhancement
  • © 2015 by American Journal of Neuroradiology

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American Journal of Neuroradiology: 36 (2)
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Cite this article
A. De Ciantis, A.J. Barkovich, M. Cosottini, C. Barba, D. Montanaro, M. Costagli, M. Tosetti, L. Biagi, W.B. Dobyns, R. Guerrini
Ultra-High-Field MR Imaging in Polymicrogyria and Epilepsy
American Journal of Neuroradiology Feb 2015, 36 (2) 309-316; DOI: 10.3174/ajnr.A4116

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Ultra-High-Field MR Imaging in Polymicrogyria and Epilepsy
A. De Ciantis, A.J. Barkovich, M. Cosottini, C. Barba, D. Montanaro, M. Costagli, M. Tosetti, L. Biagi, W.B. Dobyns, R. Guerrini
American Journal of Neuroradiology Feb 2015, 36 (2) 309-316; DOI: 10.3174/ajnr.A4116
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Cited By...

  • Detection of venous angiomas on susceptibility enhanced magnetic resonance imaging in patients with seizures
  • 7T Epilepsy Task Force Consensus Recommendations on the Use of 7T MRI in Clinical Practice
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