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CC BY-NC-ND 4.0 · Neuropediatrics 2022; 53(06): 436-439
DOI: 10.1055/a-1889-8639
Short Communication

The Role of the Three-Dimensional Edge-Enhancing Gradient Echo Sequence at 3T MRI in the Detection of Focal Cortical Dysplasia: A Technical Case Report and Literature Review

Yaeraili Abula
1   Department of Functional Neurosurgery, Neurosurgery Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
,
Ailanuer Abulimiti
2   Department of Neurology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
,
ZhengQing Liu
3   Department of Neurosurgery, Kashgar Prefecture First People's Hospital of Kashi, Kashgar, Xinjiang, China
,
Yasen Yimiti
4   Department of Medical Image, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
,
Yaermaimaiti Abula
1   Department of Functional Neurosurgery, Neurosurgery Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
,
Lei Jiang
1   Department of Functional Neurosurgery, Neurosurgery Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
,
YunLing Wang
4   Department of Medical Image, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
,
Maimaitijiang Kasimu 
1   Department of Functional Neurosurgery, Neurosurgery Centre, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
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Abstract

Introduction Focal cortical dysplasia (FCD) is a most common cause of intractable focal epilepsy in children. Surgery is considered as a radical option for such patients with the prerequisite of lesion detection. Magnetic resonance imaging (MRI) plays a significant role in detection of FCDs in epilepsy patients; however, the detection of FCDs even in epilepsy dedicated MRI sequence shows relatively low positive rate. Last year, Middlebrooks et al introduced the novel three-dimensional Edge-Enhancing Gradient Echo (3D-EDGE) MRI sequence and using this sequence successfully identified five cases of FCDs which indicates its potential role in those epilepsy patients who may have FCDs.

Case Presentation We present a 14-year-old, right-handed, male patient who has suffered from drug-resistant epilepsy over the past 3 years. It was unable to localize the lesion of the seizure, even using the series of epilepsy dedicated MRI sequences. Inspired by the previous report, the lesion of the seizure was successfully targeted by 3D-EDGE sequence. Combined with intraoperative navigation and precisely removed the lesion. He was uneventfully recovered with no signs of cerebral dysfunction and no seizure recurrence 8 months after surgery.

Conclusion The 3D-EDGE sequences show a higher sensitivity for FCD detection in epilepsy patients compared with a series of epilepsy-dedicated MRI protocols. We confirmed that the study by Middlebrooks et al is of great clinical value. If the findings on routine MRI sequences or even epilepsy-dedicated MRI sequences were reported as negative, however, the semiology, video-electroencephalography, and fluorodeoxyglucose–positron emission tomography results suggest a local abnormality, and the results are concordant with each other, a 3D-EDGE sequence may be a good option.

Keywords

3D-EDGE - focal cortical dysplasia - drug-resistant epilepsy - MRI sequences

Consent for Publication

Written consent was obtained from the patient's guardian for publication.


Supplementary Material



Publication History

Received: 04 January 2022

Accepted: 12 June 2022

Accepted Manuscript online:
01 July 2022

Article published online:
08 September 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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