title: Radiologic-pathologic correlation in focal cortical dysplasia and hemimegalencephaly in 18 children.
abstract: To describe the radiologic-pathologic correlation in children who underwent epilepsy surgery for medically intractable epilepsy with pathologically confirmed focal cortical dysplasia and hemimegalencephaly, we conducted a retrospective review on the magnetic resonance imaging and pathology of 18 children (10 boys and 8 girls). The preoperative MRIs were reviewed by one neuroradiologist who did not know the radiologic diagnosis and the pathology reports. MRI revealed focal cortical dysplasia (10), hemimegalencephaly (3), hamartomas (2), polymicrogyria (1), pial hemosiderosis (1), and no abnormality (1). Pathologic examination revealed focal cortical dysplasia (9), forme fruste of tuberous sclerosis (5), hemimegalencephaly (3), and focal cortical dysplasia with mesial temporal sclerosis (1). MRI was accurate in making the preoperative diagnosis in 16 out of 18 patients. On MRI, 12 patients had abnormal gyral formation and 12 had abnormal cortical thickness. Eleven patients manifested loss of gray-white differentiation, and 11 patients had abnormal signal on T(2)-weighted image. Pathologically, 15 patients had neuronal heterotopia, 12 had misalignment or disorientation of neurons, 11 had large neurons, and 10 had abnormal cortical lamination. The presence of ectopic and large neurons and abnormal cortical lamination may be responsible for the MRI characteristics.
authors.affiliation: Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: C L
authors.initials: CL
authors.lastname: Woo
authors.forename: S H
authors.initials: SH
authors.lastname: Chuang
authors.forename: L E
authors.initials: LE
authors.lastname: Becker
authors.forename: V
authors.initials: V
authors.lastname: Jay
authors.forename: H
authors.initials: H
authors.lastname: Otsubo
authors.forename: J T
authors.initials: JT
authors.lastname: Rutka
authors.forename: O C
authors.initials: OC
authors.lastname: Snead
mesh_terms: D001706:Biopsy; D001921:Brain / Q000002:abnormalities; D001927:Brain Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D002465:Cell Movement; D020805:Central Nervous System Viral Diseases / Q000473:pathology / Q000821:virology; D002540:Cerebral Cortex / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000473:pathology; D004827:Epilepsy / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D009474:Neurons / Q000473:pathology*; D016133:Polymerase Chain Reaction; D011859:Radiography; D012189:Retrospective Studies