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Multiple subpial transections and magnetic resonance imaging
1Department of Neurosurgery, University hospital Saint-Luc, 10, avenue Hippocrate, 1200 Brussels, Belgium.
Neuro-Chirurgie
|November 11, 2017
Summary
Multiple subpial transection (MST) for epilepsy leaves minimal MRI-visible cortical changes. T2-weighted MRI sequences, especially later scans, best show these subtle, non-complicated lesions.
Area of Science:
- Neurosurgery
- Neuroradiology
- Epileptology
Background:
- Multiple subpial transection (MST) is a surgical option for refractory epilepsy involving eloquent cortical areas.
- Limited Magnetic Resonance Imaging (MRI) data exists on the cortical effects of MST.
Purpose of the Study:
- To evaluate the post-operative cortical changes following MST using MRI.
- To identify optimal MRI sequences for visualizing MST-induced alterations.
Main Methods:
- Ten epilepsy patients undergoing MST were included.
- Post-operative MRI scans (1.5T and 3.0T) were analyzed, including intraoperative, early, and late follow-ups.
- T2 and T2* weighted sequences were prioritized for assessment.
Main Results:
- MST-induced changes were visible in all 10 patients across various MRI time points.
- T2-weighted sequences, particularly late MRI scans, best visualized MST stigmas.
- Lesions appeared as micro-hemorrhagic spots (intraoperative), cortical edema (early), and micro-cavities with hemosiderin (late).
Conclusions:
- MST results in limited, observable cortical modifications detectable by MRI.
- T2-weighted MRI sequences are optimal for assessing MST-induced cerebral lesions, especially in late post-operative scans.
