The predictive values of neuroimaging ; correlation between pathologic grades and surgical outcome in children with epilepsy.

The predictive values of neuroimaging ; correlation between pathologic grades and surgical outcome in children with epilepsy.

The predictive values of neuroimaging ; correlation between pathologic grades and surgical outcome in children with epilepsy.

(구연):
Release Date : 2009. 10. 24(토)
Yoon Hee Kim¹,Yoon Jin Lee²,Tai Seung Kim², Dong Seok Kim³, Hea Ryoung Song⁴, Heung Dong Kim¹, Joon Soo Lee¹
Department of Pediatrics,Severance hospital,Yonsei University College of medicine¹, Department of Pathology ,Severance hospital,Yonsei University College of medicine², Department of Neurosurgery,Severance hospital,Yonsei University College of medicine³, Research supporting section,Severance hospital,Yonsei University College of medicine⁴
김윤희¹,이윤진¹,김태승²,김동석³,송혜령⁴,김흥동¹,이준수¹
연세대 소아과교실¹, 연세대 병리학교실²,연세대 신경외과교실³ 연세대 의과대학 연구부⁴

Abstract

b>Purpose/b>: There has been difficulties in classifying a pathologic subtype of FCD through the various non-invasive diagnostic modalities, although the advent of diagnostic modalities has facilitated the identification of FCD. We studied how the various diagnostic modalities(EEG, MRI, PET, SPECT) can facilitate to clarify a pathologic subtype of FCD. We also studied the prognostic roles of clinical factors and various diagnostic modalities in FCD. b>Method/b>: All pediatric patients ,who were proven surgically FCD between Apr. 2003 and Jun. 2008, were analyzed retrospectively. We compared their EEG, MRI, PET and SPECT findings of FCD according to the pathologic classification by Palmini. We also studied the prognostic roles of clinical factors and various diagnostic modalities. b>Results/b>: 57 patients were enrolled.(17 microdysgenesis, 4 CDIa, 6 CDIb, 16 CDIIa, 14 CDIIb) In this study, CDIa and CD Ib were put together CDI. Among each diagnostic modalities, only PET had the statistical difference (p0.047) according the pathologic subtypes of FCD by Palmini. In combinations of diagnostic modalities, only the combined EEG and PET had the statistical meaning(p0.011). By univariate analysis, epilesy duration(p0.035) and mild pathologic subtypes(p0.045) were associated with poor surgical outcomes. By multivariate analysis, there was no specific factor associated with the surgical outcomes. The various diagnostic modalities(EEG, MRI , PET) were not associated with the surgical outcomes. b>Conclusion/b>: There is a strong tendency for patients with severe pathologic types to have PET abnormalities, and for patients with longer epilepsy duration or mild pathologic types to have a poor surgical outcome. In this study, we may find that even microdysgenesis of FCD had abnormal MRI findings, which is different from previous reports.

Keywords: focal cortical dysplasia, ,