Chinese Journal of Contemporary Neurology and Neurosurgery ›› 2025, Vol. 25 ›› Issue (3): 259-264. doi: 10.3969/j.issn.1672-6731.2025.03.013

• Clinical Study • Previous Articles     Next Articles

Clinical characteristics analysis of focal cortical dysplasia with negative MRI

Jing-tao JU1, Xin CHEN1, Jia-bin LIU1, Yong-sheng HU2, Lei-ming WANG3, Nan CHEN1,*()   

  1. 1. Department of Radiology and Nuclear Medicine, Capital Medical University, Beijing 100053, China
    2. Department of Neurosurgery, Capital Medical University, Beijing 100053, China
    3. Department of Pathology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
  • Received:2024-11-12 Online:2025-03-25 Published:2025-04-21
  • Contact: Nan CHEN
  • Supported by:
    National Natural Science Foundation of China for Young Scientists(82001374)

MRI阴性的局灶性皮质发育不良临床特征分析

俱京涛1, 陈昕1, 刘佳宾1, 胡永生2, 王雷明3, 陈楠1,*()   

  1. 1. 100053 北京,首都医科大学宣武医院放射与核医学科(俱京涛、陈昕、刘佳宾、陈楠)
    2. 100053 北京,首都医科大学宣武医院神经外科(胡永生)
    3. 100053 北京,首都医科大学宣武医院病理科(王雷明)
  • 通讯作者: 陈楠
  • 基金资助:
    国家自然科学基金青年科学基金资助项目(82001374)

Abstract:

Objective: To comparative analysis of clinical characteristics, pathological types, and prognosis of focal cortical dysplasia (FCD) with positive and negative MRI. Methods and Results: A total of 96 patients with FCD who underwent epileptic foci resection surgery at Xuanwu Hospital, Capital Medical University from January 2015 to June 2021 were selected. According to the presence of abnormal imaging findings in preoperative FLAIR imaging, patients were divided into MRI positive group (n = 39) and MRI negative group (n = 57). The proportion of FCDⅡA in the MRI negative group was higher than that in the MRI positive group (χ2 = 8.370, P = 0.004); there was a statistically significant difference in the types of epileptic seizures between the 2 groups (Fisher's exact probability: P = 0.037). Among them, the MRI negative group had a higher proportion of complete loss of consciousness seizures (Fisher's exact probability: P = 0.036) and multiple types of seizures (Fisher's exact probability: P = 0.036) than the MRI positive group, with a higher proportion of patients with focal perceptual seizures. The MRI negative group had a higher proportion of complete loss of consciousness seizures (adjusted χ2 = 4.728, P = 0.030) and multiple types of seizures (adjusted χ2 = 4.728, P = 0.030) than the MRI positive group, with a higher proportion of patients with focal perceptual deficit seizures. The proportion of postoperative epileptic seizures in the MRI negative group was higher than that in the MRI positive group (χ2 = 9.013, P = 0.003). Conclusions: The proportion of epileptic seizures in MRI negative FCD patients 2 years after surgery is higher than that in MRI positive FCD patients. The proportion of FCDⅡA in MRI negative FCD patients is higher than that in MRI positive FCD patients. MRI negative FCD patients mainly have complete loss of consciousness seizures and multiple types of seizures.

Key words: Malformations of cortical development, Epilepsy, Magnetic resonance imaging, Pathology, Prognosis

摘要:

目的: 对比分析MRI阳性与MRI阴性的局灶性皮质发育不良(FCD)临床特征、病理学类型及预后。方法与结果: 纳入2015年1月至2021年6月在首都医科大学宣武医院行致痫灶切除术的局灶性皮质发育不良患者共96例。根据术前FLAIR成像有无异常表现分为MRI阳性组(39例)和MRI阴性组(57例)。MRI阴性组FCDⅡA型比例高于MRI阳性组(χ2 = 8.370, P = 0.004)。两组癫痫发作类型差异具有统计学意义(Fisher确切概率法: P = 0.037), 其中MRI阴性组完全性失神发作(Fisher确切概率法: P = 0.036)和多种类型发作(Fisher确切概率法: P = 0.036)比例高于MRI阳性组局灶性知觉性发作患者比例, MRI阴性组完全性失神发作(校正χ2 = 4.728, P = 0.030)和多种类型发作(校正χ2 = 4.728, P = 0.030)比例高于MRI阳性组局灶性知觉障碍性发作患者比例。MRI阴性组术后癫痫发作比例高于MRI阳性组(χ2 = 9.013, P = 0.003)。结论: MRI阴性的局灶性皮质发育不良患者术后2年癫痫发作比例高于MRI阳性局灶性皮质发育不良患者, FCDⅡA型在MRI阴性患者中比例高于MRI阳性患者, MRI阴性患者多以完全性失神发作和多种类型发作为主。

关键词: 皮质发育畸形, 癫痫, 磁共振成像, 病理学, 预后