Magnetic resonance imaging (MRI) is mandatory to identify the epileptogenic zone in refractory temporal lobe epilepsy (TLE). The correct identification of lesions is essential to obtain good post-surgery seizure control. Low grade tumors (LGT) and focal cortical dysplasia (FCD) ore common findings in symptomatic TLE, and frequently coexist. The aim of thid study was to identify the MRI characteristics in the diagnosis of FDC associated with LGT. We analyzed 24 subjects with TLE who underwent tailored surgery. They all had LGTs. Two expert neuroradiologists analyzed the imaging data and compared them with histological results, hypothesizing the cases of diagnostic errors in the identification of FCD. We selected three exemplary cases to report the most important causes of errors. An incomplete MRI protocol, the large dimensions of the tumour, infiltration and related oedema were the most important factors limiting MRI accuracy. MRI can be limited by an incomplete protocol. In addition, the presence of an LGT may limit the neuroradiological diagnosis of FCD in the temporal lobe. Advanced MRI techniques could help reveal subtle lesion that eluded a previous imaging inspection.
Tarsi A, Marliani AF, Bartiromo F, Giulioni M, Marucci G, Martinoni M, et al. (2012). MRI findings in low grade tumours associated with focal cortical dysplasia. THE NEURORADIOLOGY JOURNAL, 25, 639-648.
MRI findings in low grade tumours associated with focal cortical dysplasia
LEONARDI, MARCO
2012
Abstract
Magnetic resonance imaging (MRI) is mandatory to identify the epileptogenic zone in refractory temporal lobe epilepsy (TLE). The correct identification of lesions is essential to obtain good post-surgery seizure control. Low grade tumors (LGT) and focal cortical dysplasia (FCD) ore common findings in symptomatic TLE, and frequently coexist. The aim of thid study was to identify the MRI characteristics in the diagnosis of FDC associated with LGT. We analyzed 24 subjects with TLE who underwent tailored surgery. They all had LGTs. Two expert neuroradiologists analyzed the imaging data and compared them with histological results, hypothesizing the cases of diagnostic errors in the identification of FCD. We selected three exemplary cases to report the most important causes of errors. An incomplete MRI protocol, the large dimensions of the tumour, infiltration and related oedema were the most important factors limiting MRI accuracy. MRI can be limited by an incomplete protocol. In addition, the presence of an LGT may limit the neuroradiological diagnosis of FCD in the temporal lobe. Advanced MRI techniques could help reveal subtle lesion that eluded a previous imaging inspection.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
