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Double inversion recovery MRI of subcortical band heterotopia and its variations
Emiko Chiba1, Noriko Sato1, Yukio Kimura1
1Department of Radiology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan.
Background And Purpose:
Subcortical band heterotopia (SBH) is a malformation of cortical development diagnosed via MRI. Currently, patients with SBH are classified according to Di Donato's classification. We aimed to show a variation of SBH and the usefulness of double inversion recovery (DIR) images.
Methods:
We retrospectively reviewed the MRI findings of 28 patients with SBH. The patients were classified according to Donato's classification by using conventional MR images, and their DIR findings were reviewed.
Results:
Of 28 patients, 20 were grade 1 and 8 were grade 2 according to Di Donato's classification. In 15 of 28 patients, the following four types of atypical MRI findings were detected: asymmetry distribution (four cases), coexistence of thin and thick SBH (five cases), and DIR faint abnormal signal intensity in subcortical white matter (five cases) and in deep white matter (five cases). The latter two types were detected on DIR alone and have not been reported. Additionally, these were identified only in the mild group (Di Donato's classification 1-1 or 1-2).
Conclusion:
DIR is a useful MRI sequence for detecting faint white matter signal abnormalities, and it can aid in the accurate classification of SBH and identification of its variations, which may reflect the pathology of SBH.
Insights
Double inversion recovery (DIR) MRI images reveal atypical subcortical band heterotopia (SBH) variations not seen on conventional scans. DIR aids in accurate classification and understanding SBH pathology.
Area of Science:
- Neuroradiology
- Neuroimaging
- Developmental Neuroscience
Background:
- Subcortical band heterotopia (SBH) is a congenital malformation of cortical development.
- Current classification relies on Di Donato's system using conventional MRI.
- Variations in SBH may indicate underlying pathological differences.
Purpose of the Study:
- To identify variations in SBH using MRI.
- To evaluate the utility of double inversion recovery (DIR) sequences in SBH assessment.
- To demonstrate DIR's role in refining SBH classification.
Main Methods:
- Retrospective review of MRI scans from 28 SBH patients.
- Classification of SBH using Di Donato's criteria on conventional MRI.
- Detailed analysis of DIR MRI findings in all patients.
Main Results:
- 15 out of 28 patients exhibited atypical SBH findings.
- Identified variations include asymmetric distribution, coexistence of thin/thick bands, and faint white matter signal abnormalities on DIR.
- DIR detected novel signal abnormalities in subcortical and deep white matter, primarily in milder SBH cases (Di Donato grade 1).
Conclusions:
- DIR is a valuable MRI sequence for detecting subtle white matter abnormalities in SBH.
- DIR imaging enhances the accurate classification of SBH.
- DIR can identify SBH variations, potentially offering insights into the condition's pathology.
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