Morphological analysis of brain MRI and its application in focal cortical dysplasia

Abstract

Objective To investigate the clinical value of MRI morphological analysis in identification of focal cortical dysplasia (FCD) in presurgical evaluation of epileptogenic zone (EZ). Methods We retrospectively analyzed the clinical data of 53 patients who were admitted to Epilepsy Center, Tsinghua University Yuquan Hospital and underwent surgical removal of epileptic foci and were pathologically confirmed as FCD Ⅰ or FCD Ⅱ. Morphometric analysis programme was used to post-process presurgical high-resolution MRI to obtain the gray-white matter junction imaging (MAP+ region) and statistical analysis was used to determine the consistency of the MAP+ region and surgical site and postoperative epilepsy control. Results In this series, the probability of postoperative seizure-free (67.9%, 36/53) was higher in patients whose MAP+ regions were resected than that (7.5%, 4/53) in patients whose MAP+ regions were not resected (P=0.002). In the MRI-negative group, the probability of postoperative seizure-free (62.5%, 20/32) was higher in patients whose MAP+ regions were resected than that (9.4%, 3/32) in patients whose MAP+ regions were not resected (P=0.006). In the MRI positive group, MAP+ regional resection was not associated with the clinical outcome (P=0.352). Conclusions The gray-white matter junction imaging could improve the detection rate of FCD lesions, which might have clinical value in localization of EZ and resection of EZ and making electrode plan of stereotactic electroencephalogram (SEEG). Key words: Epilepsy; Malformations of cortical development; Gray matter and white matter junction imaging; Morphometric analysis programme