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FDG-PET improves surgical outcome in negative MRI Taylor-type focal cortical dysplasias.
Chassoux, F; Rodrigo, S; Semah, F; Beuvon, F; Landre, E; Devaux, B; Turak, B; Mellerio, C; Meder, J-F; Roux, F-X; Daumas-Duport, C; Merlet, P; Dulac, O; Chiron, C.
Afiliação
  • Chassoux F; Departments of Neurosurgery, Centre Hospitalier Sainte-Anne, Paris, France. f.chassoux@ch-sainte-anne.fr
Neurology ; 75(24): 2168-75, 2010 Dec 14.
Article em En | MEDLINE | ID: mdl-21172840
OBJECTIVE: To determine the diagnostic accuracy and prognostic value of ¹8FDG-PET in a recent series of patients operated for intractable partial epilepsy associated with histologically proven Taylor-type focal cortical dysplasia (TTFCD) and negative MRI. METHODS: Of 23 consecutive patients (12 male, 7-38 years old) with negative 1.5-Tesla MRI, 10 exhibited subtle nonspecific abnormalities (e.g., unusual sulcus depth or gyral pattern) and the 13 others had strictly normal MRI. FDG-PET was analyzed both visually after coregistration on MRI and using SPM5 software. Metabolic data were compared with the epileptogenic zone (EZ) determined by stereo-EEG (SEEG) and surgical outcome. RESULTS: Visual PET analysis disclosed a focal or regional hypometabolism in 18 cases (78%) corresponding to a single gyrus (n = 9) or a larger cortical region (n = 9). PET/MRI coregistration detected a partially hypometabolic gyrus in 4 additional cases. SPM5 PET analysis (n = 18) was concordant with visual analysis in 13 cases. Location of PET abnormalities was extratemporal in all cases, involving eloquent cortex in 15 (65%). Correlations between SEEG, PET/MRI, and histologic findings (n = 20) demonstrated that single hypometabolic gyri (n = 11) corresponded to EZ and TTFCD, which was localized at the bottom of the sulcus. Larger hypometabolic areas (n = 9) also included the EZ and the dysplastic cortex but were more extensive. Following limited cortical resection (mean follow-up 4 years), seizure freedom without permanent motor deficit was obtained in 20/23 patients (87%). CONCLUSIONS: ¹8FDG-PET coregistered with MRI is highly sensitive to detect TTFCD and greatly improves diagnosis and surgical prognosis of patients with negative MRI.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Córtex Cerebral / Epilepsias Parciais / Tomografia por Emissão de Pósitrons Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: Neurology Ano de publicação: 2010 Tipo de documento: Article País de afiliação: França

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Imageamento por Ressonância Magnética / Córtex Cerebral / Epilepsias Parciais / Tomografia por Emissão de Pósitrons Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: Neurology Ano de publicação: 2010 Tipo de documento: Article País de afiliação: França