title: Ultra-high-field MR imaging in polymicrogyria and epilepsy.
abstract: OBJECTIVE
  Polymicrogyria is a malformation of cortical development that is often identified in children with epilepsy or delayed development. We investigated in vivo the potential of 7T imaging in characterizing polymicrogyria to determine whether additional features could be identified.
  
  
  METHODS
  Ten adult patients with polymicrogyria previously diagnosed by using 3T MR imaging underwent additional imaging at 7T. We assessed polymicrogyria according to topographic pattern, extent, symmetry, and morphology. Additional imaging sequences at 7T included 3D T2* susceptibility-weighted angiography and 2D tissue border enhancement FSE inversion recovery. Minimum intensity projections were used to assess the potential of the susceptibility-weighted angiography sequence for depiction of cerebral veins.
  
  
  RESULTS
  At 7T, we observed perisylvian polymicrogyria that was bilateral in 6 patients, unilateral in 3, and diffuse in 1. Four of the 6 bilateral abnormalities had been considered unilateral at 3T. While 3T imaging revealed 2 morphologic categories (coarse, delicate), 7T susceptibility-weighted angiography images disclosed a uniform ribbonlike pattern. Susceptibility-weighted angiography revealed numerous dilated superficial veins in all polymicrogyric areas. Tissue border enhancement imaging depicted a hypointense line corresponding to the gray-white interface, providing a high definition of the borders and, thereby, improving detection of the polymicrogyric cortex.
  
  
  CONCLUSIONS
  7T imaging reveals more anatomic details of polymicrogyria compared with 3T conventional sequences, with potential implications for diagnosis, genetic studies, and surgical treatment of associated epilepsy. Abnormalities of cortical veins may suggest a role for vascular dysgenesis in pathogenesis.
authors.affiliation: From the Pediatric Neurology Unit (A.D.C., C.B., R.G.), Meyer Children's Hospital, University of Florence, Florence, Italy.
authors.forename: A
authors.initials: A
authors.lastname: De Ciantis
authors.affiliation: Department of Radiology and Biomedical Imaging (A.J.B.), University of California San Francisco, San Francisco, California.
authors.forename: A J
authors.initials: AJ
authors.lastname: Barkovich
authors.affiliation: Department of Translational Research and New Technologies in Medicine and Surgery (M. Cosottini), University of Pisa, Pisa, Italy IMAGO7 Foundation (M. Cosottini), Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Cosottini
authors.affiliation: From the Pediatric Neurology Unit (A.D.C., C.B., R.G.), Meyer Children's Hospital, University of Florence, Florence, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Barba
authors.affiliation: Fondazione Consiglio Nazionale delle Ricerche/Regione Toscana (D.M.), Unità Operativa Semplice Neuroradiologia, Pisa, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Montanaro
authors.affiliation: Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (M. Costagli, M.T., L.B., R.G.), Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Costagli
authors.affiliation: Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (M. Costagli, M.T., L.B., R.G.), Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Tosetti
authors.affiliation: Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (M. Costagli, M.T., L.B., R.G.), Pisa, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Biagi
authors.affiliation: Center for Integrative Brain Research (W.B.D.), Seattle Children's Hospital, Seattle, Washington.
authors.forename: W B
authors.initials: WB
authors.lastname: Dobyns
authors.affiliation: From the Pediatric Neurology Unit (A.D.C., C.B., R.G.), Meyer Children's Hospital, University of Florence, Florence, Italy Istituto di Ricovero e Cura a Carattere Scientifico Stella Maris Foundation (M. Costagli, M.T., L.B., R.G.), Pisa, Italy renzo.guerrini@unifi.it.
authors.forename: R
authors.initials: R
authors.lastname: Guerrini
mesh_terms: D000293:Adolescent; D000328:Adult; D002533:Cerebral Angiography / Q000379:methods; D002540:Cerebral Cortex / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods*; D065706:Polymicrogyria / Q000150:complications / Q000473:pathology*