Simona Gaudino MD, Presenter: Nothing to Disclose

Tommaso Tartaglione MD, Abstract Co-Author: Nothing to Disclose

Francesca Piludu MD, Abstract Co-Author: Nothing to Disclose

Giuseppe M. Di Lella MD, Abstract Co-Author: Nothing to Disclose

Rosalinda Calandrelli, Abstract Co-Author: Nothing to Disclose

Cesare Colosimo MD, Abstract Co-Author: Research Consultant, Bayer AG Research Consultant, Bracco Group

We retrospectively reviewed histological and MRI findings of 15 pts with focal cortical dysplasia (FCD), which underwent surgical resection for drug resistant epilepsy. We aimed to: •evaluate whether MRI findings could correlate with histopatological features •define distinctive MRI findings for each types and subtypes of FCD •determine the value of 3D IR-prepped High Resolution (3D-IRHR)T1-wi to identify distinct imaging characteristics of different histopathological types of FCD.

We reviewed clinical, histological and MR data of 15 children with histologically proven diagnosis of FCD that was classified as Taylor-type (TFCD:subtype IIA and IIB) and no Taylor-type (nTFCD:subtype IA and IB MRI protocol consist at least of high resolution FSE T2-wi,FLAIR-wi and 3D-IRHR We assessed: focal cortical thickening, blurring of GM/WM junction, “transmantle” sign, sulcal/gyral abnormal pattern, lobar hypoplasia, WM core atrophy, abnormalities of cortical GM, abnormalities of subcortical WM, hippocampal abnormalities. We collected clinical pre- and post-surgical data

• 7 cases of TFCD (six IIB subtype, one IIA subtype), 8 cases of nTFCD. • In TFCD 3D-IRHR T1-wi demonstrated: increased cortical thickness (6-10 mm), marked GM/WM junction blurring, signal abnormalities of cortical GM and subcortical WM. Simplified sulcal pattern and core atrophy of WM were also imaged. FLAIR and T2-wi identified: cortical GM and subcortical WM abnormalities • In nTFCD 3D-IRHR T1-wi demonstrated cortical thickness (5-9 mm), moderate to marked GM/WM junction blurring, simplified sulcal pattern. FLAIR and T2-wi identified slight to prominent hyperintensity of subcortical WM and slight abnormalities in dysplastic cerebral cortex. •There was a trend toward better surgical outcomes in FCD type II compared with FCD type I pts.  

MRI can differentiate TCFD from nTCFD but not subtypes 3D-IRHR T1-wi allowed to identify 2 distinct imaging characteristics of TCFD: 1-hypointensity of subcortical WM (that could reach periventricular WM); 2-hyperintensity of dysplastic cortex. These findings are probably connected to marked cortical disorganization and neuronal morphological abnormalities associated with TCFD

MRI can differentiate TCFD from nTCFD,but not subtypes 3D-IRHR has a prominent role in evaluating imaging characteristics of CFD

Gaudino, S, Tartaglione, T, Piludu, F, Di Lella, G, Calandrelli, R, Colosimo, C, MR Characteristics of Different Histological Subtypes of Focal Cortical Dysplasia (FCD): Our Pathologically Proven Case Series.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9007981.html