不同病理分型局部脑皮质发育不良的MRI研究

目的 探讨不同病理分型局部脑皮质发育不良(FCD)在MRI表现上的特点.方法 回顾性分析广州医学院第二附属医院自2006年5月至2010年6月收治的23例FCD患者资料.所有患者均经手术病理证实,按Palmini方法FCDⅠA、FCDⅠB、FCDⅡA、FCDⅡB4型,总结各类型患者MRI表现的特点.结果 23例患者中FCD Ⅰ A 2例,FeD Ⅰ B 6例,FCDⅡA 8例,FCDⅡB7例.FCDⅡ型中,有11例MRI表现为病灶Flair高信号,Ⅰ型中仅有2例,差异有统计学意义(P=0.039).而病灶T2高信号、白质内向脑室延伸带等表现虽然在Ⅰ、Ⅱ型间相差较大,但差异没有统计学意义(P=0.074、0.058).ⅡB型的MRI表现在灰白质分界不清、病灶T2高信号、脑沟加深、灰质增厚、白质内向脑室延伸带等方面均明显高于其他3型,差异有统计学意义(P<0.05).结论 不同病理分型FeD的MRI表现各有特点,特别是ⅡB型,其在MRI上的表现与其他3型明显不同,了解这些特点有助于FCD的早期诊断和术前评估.

MRI characteristics of different pathologic types of focal cortical dysplasia

Objective To investigate the MRI characteristics of different pathologic types of patients with focal cortical dysplasia (FCD). Methods The postoperative clinical data of 23 patients with FCD were retrospectively analyzed and they were divided into patient groups of 4 types according to Palmini' s classification. The MRI characteristics of different pathologic types of patients with FCD were concluded. Results Among these 23 patients, 2 were diagnosed as having FCD ⅠA, 6 as having FCD IB, 8 as having FCD ⅡA and 7 as having FCD IE. As compared with that in patients with FCD Ⅰ, obviously increased signal of Flair images in patients with FCD Ⅱ was more prevalent (2:11,P=0.039). Increased signal in T2 images and tapering of abnormal white matter signals to ventricles were more prevalent in patients with FCD Ⅱ as compared with those in patients with FCD Ⅰ, but no significant differences were noted (P= 0.074, 0.058). As compared with patients with other 3 types of FCD, blurring of the gray matter-white matter junction, increased signal in T2 images, deep sulcus, thickening of the cortex and tapering of abnormal white matter signals to ventricles in patients with FCD ⅡB were more prevalent (P<0.05). Conclusion Different MRI characteristics in each type of FCD are noted, especially in patients with FCDⅡB. These different MRI characteristics are helpful to make preoperative diagnosis and planning of FCD.