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KMID : 0858520170210020082
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Journal of the Korean Society of Magnetic Resonance in Medicine
2017 Volume.21 No. 2 p.82 ~ p.90
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MR Findings of Seizure-Related Cerebral Cortical Lesions during Periictal Period
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Kim Na-Yoon
Baek Hye-Jin
Choi Dae-Seob
Ha Jee-Young
Shin Hwa-Seon
Kim Ju-Ho
Choi Ho-Cheol
Kim Ji-Eun
Park Mi-Jung
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Abstract
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Purpose: This study investigated the MRI, MR angiography (MRA) and MR perfusion findings of seizure-related cerebral cortical lesions during the periictal period.
Materials and Methods: From a retrospective review of the institutional database between 2011 and 2014, a total of 21 patients were included in this study. Two radiologists assessed periictal MRI, including MRA and MR perfusion, in patients with seizure-related cortical lesions. The parameters examined include: location of cortical abnormality, multiplicity of the affected cortical region, cerebral vascular dilatation, perfusion abnormality and other parenchymal lesions.
Results: All patients showed T2 hyperintense cerebral cortical lesions with accompanying diffusion restriction, either unilateral (18/21, 85.7%) or bilateral (3/21, 14.3%). Of the 21 patients enrolled, 10 (47.6%) had concurrent T2 hyperintense thalamic lesions, and 10 (47.6%) showed hippocampal involvement. Of the 17 patients (81%) who underwent MRA, 13 (76.5%) showed vascular dilatation with increased flow signal in the cerebral arteries of the affected cortical regions. On MR perfusion, all 5 patients showed cortical hyperperfusion, corresponding to the region of cortical abnormalities.
Conclusion: Seizure-related cerebral cortical lesions are characterized by T2 and diffusion hyperintensities, with corresponding cerebral hyperperfusion and vascular dilatation. These findings can be helpful for making an accurate diagnosis in patients with seizure.
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KEYWORD
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Seizure, Cortical hyperintensity, Periictal period, Magnetic resonance imaging, Magnetic resonance angiography, Magnetic resonance perfusion
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