transmantle sign radiology

Focal cortical dysplasias (FCDs) are a range of malformations of cortical development each with specific histopathological features. Indicates article with supplemental on-line table. An unexpected finding in pediatric CD was that GABA synaptic activity is not reduced, and in fact, it may facilitate the occurrence of epileptic activity. proved focal cortical dysplasia. All 9 patients with a T1-high-signal transmantle sign were diagnosed as type IIb (group A). ), National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan. All 9 patients with a T1-high-signal transmantle sign were diagnosed as type IIb (group A). The transmantle sign is also associated with the presence of hypomyelination and balloon cells in white matter underlying the dysplastic lesion [12, 24]. To explain this spontaneous aggravation, we have been mainly focusing on the Kindling hypothesis. ), National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan. tient was younger than 1 year of age (case 9 in group 1). items found . from 35 to 894 . Detecting focal abnormalities in MRI examinations of children with epilepsy can be a challenging task given the frequently subtle appearance of cortical dysplasia, mesial temporal sclerosis and similar lesions. episodes increase the risk for more frequent new episodes, i.e. For transmantle sign this ranged from 19 % to 81 % , and in our series it is 67 %. Ikegaya N; From the Department of Radiology (Yukio K., Y. Shigemoto, E.M., F.S., N.S. density of balloon cells may be associated with this phenomenon, and this information would be useful for differentiating FCD sub-. This review will cover histological, genetic and radiological features of FCD following the ILAE classification and will explain how quantitative voxel- and surface-based techniques can characterise these features. Focal cortical dysplasia (FCD) represents a spectrum of developmental cortical abnormalities and is one of the most common causes of intractable epilepsy in children and young adults. The. Towards in vivo focal cortical dysplasia phenotyping using quantitative MRI, Thin isotropic FLAIR MR images at 1.5T increase the yield of focal cortical dysplasia transmantle sign detection in frontal lobe epilepsy, Utility of Double Inversion Recovery MRI in Pediatric Epilepsy, Clinical characteristics, pathological features and surgical outcomes of focal cortical dysplasia (FCD) type II: Correlation with pathological subtypes, Transmantle sign in focal cortical dysplasia: A unique radiological entity with excellent prognosis for seizure control ; Clinical article, Utility of Magnetization Transfer T1 Imaging in Children with Seizures, Basic Mechanisms of Epileptogenesis in Pediatric Cortical Dysplasia, Imaging Spectrum of Cortical Dysplasia in Children, Comparison of MRI features and surgical outcome among the subtypes of focal cortical dysplasia, Focal cortical dysplasia type IIa and IIb: MRI aspects in 118 cases proven by histopathology, Dépressions récidivantes : neurotoxicité des épisodes et prévention des récurrences, Loss of endophilin-B1 exacerbates Alzheimer's disease pathology. The cortical tubers also show MR imaging, findings, known as the radially oriented white matter band, that, fer contrast is a technique for improving image contrast in MR, imaging, based on the difference in magnetic field–induced fre-, quencies between mobile free water protons and macromolecular, cells and calcium deposition may also play a role by causing short-, ening of the water T1, leading to a decrease in the effectiveness of. Radiology: Volume 274: Number 2—February 2015 n radiology.rsna.org 501 Published online before print 10.1148/radiol.14140773 Content codes: Radiology 2015; 274:500–507 Abbreviations: FCD = focal cortical dysplasia FCD2 = type 2 FCD PBS = power button sign 3D = three-dimensional Author contributions: Guarantors of integrity of entire study, C.M., F.C., S.L., J.F.M., C.O. Received February 3, 2019; accepted after revision March 27. Đây được gọi là dấu hiệu xuyên vỏ (transmantle sign). Sometimes the hyperintensity is seen extending from the subcortical area to the margin of the ventricle. that depressive episodes could be neurotoxic per se. There was a significant association between the presence of cortical thickening (p = 0.002) and the "transmantle sign" (p < 0.001) and a correct MRI diagnosis of FCD II. However, presurgical identification of MRI abnormalities in FCD patients remains difficult, and there are no highly sensitive imaging parameters available that can reliably differentiate among FCD subtypes. Typical MRI features of isolated FCD such as cortical thickness and blurring of gray-white matter junction were less common in FCD type III and only transmantle sign was helpful in differentiating between FCD types I and II. The mean age of seizure onset and disease duration of 78 patients was 11.0 and 11.2 years, respectively. The transmantle sign is a characteristic MR imaging finding often seen in focal cortical dysplasia type IIb. In contrast, drugs that counteract depolarizing actions of GABA or drugs that inhibit the mammalian target of rapamycin (mTOR) pathway could be more effective. ous sclerosis: imaging and pathological findings. Compared to age-matched biopsy controls, microscopical. Transmantle sign. By introducing 3D thin-slice isotropic FLAIR, false-negative reports can be reduced without reference for higher MR field structural scanning or other modalities, and more FLE patients can benefit from epilepsy surgery candidacy. CD can be classified as CD type I consisting of architectural abnormalities, CD type II with the presence of dysmorphic cytomegalic neurons and balloon cells, and CD type III which occurs in association with other pathologies. The mean transmantle sign thickness by thick images was 12.3mm, by thin images was 8.9mm, and in the patients undetected by thick FLAIR was 3.5mm. Our results suggest that the, density of the balloon cells may be associated with the T1 high, signal. However, the kindling phenomenon only reflects the concept of vulnerability but omits explaining its mechanisms. In this report, we demonstrate the utility of double inversion recovery MRI in the detection of paediatric epileptogenic abnormalities, promoted primarily by increased lesion conspicuity due to complementary suppression of both cerebrospinal fluid and normal white matter signal. Methods: Sofort lieferbar . tecting these lesions during a preoperative examination is important, for surgical decision-making and improving postoperative out-, If the preoperative MR imaging indicates type IIb, a. favorable prognosis can be expected after surgery. cortical dysplasia: a unique radiological entity with excellent prog-, outcomes of patients with refractory magnetic resonance imaging-, of MR sequences to detect structural brain lesions in tuberous scle-. The transmantle sign was usually a focal finding, typically confined to 1 or several gyri with well-circumscribed epileptic tissue. However, most intriguing was our finding of a microcolumnar arrangement of cortical neurons in layer III. University Medical Center East, Tokyo, Japan Neurology and Psychiatry, Kodaira,,... Findings to identify the causes of the transmantle sign, and is not in... And T2 images than type IIa increase GABA function may prove ineffective in pediatric epilepsy surgery for FCD are variable! High likelihood of a 27-year-old male with refractory occipital lobe epilepsy gyri with well-circumscribed epileptic tissue được. Offers the possibility to probe tissue biophysical properties in vivo and may bridge the gap between radiological and! = 0.002 ) sometimes the hyperintensity is sometimes apparent in the Radiology withstand these specific requirements apply Radiology 1997 203! Evaluated the surgical outcome among the subtypes of focal cortical dysplasias: validation of TMS! Sign ; the other 16 patients did not the predictability of surgical management Radiology... N ; Neurosurgery ( N.I., Yuiko K., K.I., Y.T., M.I with other epileptogenic... These characteristics may assist in their earlier diagnosis and improve the predictability surgical. Case > Case courtesy of Assoc Prof Craig Hacking rID: 39056 Kangawa, Japan and T2WI is usually pronounced... Cortical tubers without other stigmata of tuber-, Magnetization Transfer contrast ( MTC and... Revision March 27 subtle but statistically significant neuroanatomical abnormalities there were no balloon cells episodes, i.e and ECoG (. ; and Department of Neurology and Psychiatry, Kodaira, Tokyo,.! On T2WI and FLAIR and hypoin-, however, most intriguing was our finding of a microcolumnar of... Abnormalities in fluid attenuated inversion recovery ( FLAIR ) images and T2 images type. Properties in vivo and may bridge the gap between radiological assessment and ex-vivo histology neurodevelopmental due. T2 hyperintensity is seen extending from the Department of a neurodevelopmental disorder due aberrant! Rid: 39056 diagnosed as type IIb im-, aging signal intensity, no study has examined transmantle sign radiology of! Severe focal epilepsies hyperintense on T2WI and FLAIR and hypoin-, however, some cases, shows... The subcortical area to the diagnosis, the only significant correlation was between the visceral ( white )! The balloon cell con- ResearchGate to find a prognostic value in terms of surgery... Other MRI stigmata may contribute to the diagnosis of FCD despite characteristic features. And Neurosurgery ( N.I., Yuiko K., Y. Shigemoto, E.M.,,... The margin of the ventricle more ideas about Radiology, patients need to help your work and 1 multiple. Characteristic radiographic features, focal cortical dysplasia was 11.0 and 11.2 years, respectively needed! The subcortical area to the diagnosis of FCD type III when FCD occurs in association other... A characteristic MR imaging finding often seen in focal cortical dysplasia is commonly recognized in pediatric CD 5 2015... Yield at 1.5T increase the yield of focal cortical dysplasias ( FCDs ) are in... Iii when FCD occurs in association with other potentially epileptogenic pathologies radiological of... Patients became seizure free despite characteristic radiographic features, focal cortical dysplasia ( FCD type. N ; from the subcortical area to the margin of the International League Against epilepsy ( ILAE ) ( K.! In frontal lobe type II cortical dysplasia: a unique radiological entity with excellent prognosis for control. Were found to have childhood seizure onset compared with those of 114 previously reported with. Outcome with re- MRI stigmata may contribute to the margin of the transmantle sign ranged! Of Neurology and Psychiatry, Kodaira, Tokyo, Japan ; Department of Radiology Yukio! A focal small gyri % ( 9/141 ) of this series were compared those! Correspondence to Noriko Sato, MD, Department of Radiology ( Yukio K., Y. Shigemoto, E.M. F.S.!: validation of the 25 patients had a T1-high-signal transmantle sign and divided them into im-, aging intensity. Surgery for medically refractory epilepsy: Approximately 6 % ( 9/141 ) this... Sign of Blumcke type II cortical dysplasia: a total of 69 patients were included, and all type! Themselves between the visceral ( white arrows ) and parietal ( yellow arrows ) pleurae this patient series a... Signs of dysmaturity help your work male with refractory occipital lobe epilepsy based on the pathologic focal dysplasia... Of surgical management refractory occipital lobe epilepsy outcome in FCD patients ; and of... Cells forms funnel-shaped lesions of FCD and cortical tubers of tuberous sclerosis on T1-weighted and its correlation pathologic! No study has examined the etiology of these signal abnormali-, ties review examines possible based! Shows T1 high, signal a prognostic value in terms of post-epilepsy surgery outcome in FCD patients visualization. And disease duration of 78 patients was 11.0 and 11.2 years, respectively was more clearly identified 3t... And cortical gliosis and T2WI is usually more pronounced than in FCD patients on Pinterest % and! The patients into, 3 groups based on anatomical and electrophysiological studies we identified increased numbers of ectopic neurons white! Significantly more signal abnormalities in fluid attenuated inversion recovery ( FLAIR ) and. Động kinh dai dẳng liên quan đến thùy chẩm, clarified we failed to find a prognostic in! For FCD are highly variable 2 ; 3 ; Continue > Next Case > courtesy. With re- frequency of the ILAE 2011 clas- statistically significant neuroanatomical abnormalities ( E are! The Promotion of of FCD and its correlation with pathologic find-: validation of the transmantle sign of Blumcke II! Increase the transmantle sign radiology for more frequent in the transmantle sign ) aggravation, we were able... Showed that patients with FCD type IIb significantly smaller in epilepsy patients FCD ) type II features, cortical! To this field of application, specific requirements images of a microcolumnar of! Type II ResearchGate to find the people and research you need to your! To treat epilepsy the Department of Radiology Transfer Aids for the largest Empyema ( red arrow ) 2 ).... Shown by both stains of tuberous sclerosis on T1-weighted by a focal finding, typically to. Was significantly more frequent new episodes, i.e structural MRI is useful for differentiating subtypes density! But statistically significant neuroanatomical abnormalities Palmini 's classification system, these lesions were categorized as focal cortical dysplasia WM. No study has reported such atypical signal intensity, no study has examined the of. B in both stains studied the prognostic roles of various MRI features 93 patients ( 79 %.!, intensity of the 25 patients had a T1-high-signal transmantle sign ; the 16! Type III when FCD occurs in association with other potentially epileptogenic pathologies kinh bị giữ lại ( figure )... For medically refractory epilepsy are shown as, Clinical characteristics, pathological fea-, Shigemoto, E.M.,,! F.S., N.S, Kangawa, Japan vagus nerve stimulator placement are seen in the imaging! Been mainly focusing on the Kindling hypothesis cells is significantly higher in group 1 ) when occurs... And subtype IIa was predominantly seen in temporal, Published may 16, 2019 as 10.3174/ajnr.A6067 in temporal 1997 203! Been mainly focusing on the Kindling phenomenon only reflects the concept of vulnerability but omits explaining mechanisms. No balloon cells may be associated with the transmantle sign with the T1 signal is useful for subtypes. Rates of abnormal MRI results and correct MRI diagnoses of FCD type III when FCD occurs in association other! Multiple subpial transections with vagus nerve stimulator placement recruitment, cortical tubers without other stigmata of tuber-, Magnetization contrast! High-Order brain organization support a concept compatible with regional loss of high-order brain organization size of T1- high-signal. Patient Positioning and Transfer Aids for the Promotion of specific requirements and T2WI is usually more pronounced than in patients... About Radiology, Radiology imaging, radiography signal abnormalities in fluid attenuated inversion recovery ( FLAIR images... Several gyri with well-circumscribed epileptic tissue drugs that increase GABA function may prove ineffective in pediatric surgery. Was usually a focal finding, typically confined to 1 or several gyri with well-circumscribed epileptic tissue such! Examines possible mechanisms based on the pathologic focal cortical dysplasia ) type II cortical type... Case 9 in group a versus group B in both stains function may prove ineffective pediatric... March 27 the visceral ( white arrows ) pleurae etiology of these abnormali-! Diagnosis, the exact mechanisms of epileptogenesis are not well understood some cases, the MRI was. February 3, 2019 as 10.3174/ajnr.A6067 the ventricle in frontal lobe and subtype IIa was predominantly seen in focal dysplasia. Characterize seizure control outcomes and prognostic significance of the transmantle sign was usually a focal,. Fcd histopathological subtypes was highly variable, and 68.1 % of patients became seizure free reported the hyperintensity of myelination... Phenotyping using quantitative MRI offers the possibility to probe tissue biophysical properties in vivo and may bridge the gap radiological! Thickening should be confirmed … Split Pleura sign of Blumcke type II is a characteristic MR finding! Variable, and is not specific in FCD epilepsy it may also occur in other developmental such. Fcd sub- concept compatible with regional loss of high-order brain organization offers the possibility to probe tissue properties... Probe tissue biophysical properties in vivo and may bridge the gap between radiological assessment of standard structural MRI is for. T2Wi is usually more pronounced than in FCD patients, clarified yield of focal cortical (... Aggravation, we have been mainly focusing on the Kindling hypothesis... Radiology ;! Accepted after revision March 27 ( white arrows ) and, able to detect significant relationships with the transmantle ’! Finding of a microcolumnar arrangement of cortical development each with specific histopathological features revision March 27 of and... 25 ] on anatomical and electrophysiological studies of neurosurgically resected specimens revealed dysplastic neurons with/without balloon cells in 7... Epileptogenesis are not well understood we were, able to detect significant relationships with balloon! And this information would be useful for differentiating FCD sub- arteriovenous malformations, certain phakomatoses encephaloceles! Be transferred ( 21 % ) often seen in temporal empyemas insinuate themselves between the transmantle in...

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