Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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Three-Dimensional Brain Surface Rendering Imaging of Cortical Dysplasia

뇌피질 이형성증의 3차원 뇌표면 연출영상

  • Hwang, Seung-Bae (Department of Radiology, Chonbuk National University Medical School) ;
  • Kwak, Hyo-Sung (Department of Radiology, Chonbuk National University Medical School) ;
  • Lee, Sang-Yong (Department of Radiology, Chonbuk National University Medical School) ;
  • Jin, Gong-Yong (Department of Radiology, Chonbuk National University Medical School) ;
  • Han, Young-Min (Department of Radiology, Chonbuk National University Medical School) ;
  • Chung, Gyung-Ho (Department of Radiology, Chonbuk National University Medical School)
  • 황승배 (전북대학교 의학전문대학원 영상의학과) ;
  • 곽효성 (전북대학교 의학전문대학원 영상의학과) ;
  • 이상용 (전북대학교 의학전문대학원 영상의학과) ;
  • 진공용 (전북대학교 의학전문대학원 영상의학과) ;
  • 한영민 (전북대학교 의학전문대학원 영상의학과) ;
  • 정경호 (전북대학교 의학전문대학원 영상의학과)
  • Received : 2010.08.13
  • Accepted : 2010.11.17
  • Published : 2010.12.30
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Abstract

Purpose : The study was to evaluate the localization of the abnormal gyral and sulcal patterns obtained by means of brain surface rendering imaging. Materials and Methods : Nineteen patients with cortical dysplasia who underwent brain surface rendering MR imaging were included in this study. We acquired MP-RAGE sequence and created the 3-D surface rendering MR images by using $VoxelPlus^{(R)}$. Anatomical locations and configurations of abnormal gyri and sulci were reviewed. Results : Abnormal gyral and sulcal patterns were seen 18 in 19 patients. The configuration and orientation of affected gyri and sulci were clearly evaluated in the brain surface rendering images. In a lissencephaly, the a cortex was not delineated and showed markedly thick and smooth gyral pattern. In a schizencephaly, there were wheel shaped broad gyral pattern around the cleft. In a hemimegalencephaly, an affected hemisphere were enlarged and displayed thick and wide gyral pattern. In CBPS, the insular cortex was exposed and the gyri of the lesion were thickened. In focal cortical dysplasia, there were irregular serrated or thick and enlarged gyri. Conclusion : Brain surface rendering MR imaging is useful for the evaluation of a detailed gyral pattern and accurate involvement site of abnormal gyri.

목적 : 뇌피질이형성증에서 3차원 뇌표면연출영상의 유용성을 평가하고자 하였다. 대상 및 방법 : 19명의 국소적 뇌피질이형성증을 대상으로 MP-RAGE영상을 이용하여 3차원 뇌 표면연출영상을 얻었다. 비정상적인 뇌이랑과 뇌고랑의 해부학적 위치, 침범부위의 뇌이랑과 뇌고랑의 형태와 모양을 평가하였다. 결과 : 비정상적인 뇌이랑과 뇌고랑의 모양은 19명 중 18명의 환자에서 관찰되었다. 병변 부위의 뇌이랑과 뇌고랑의 형태와 배열, 침범모양은 뇌표면연출영상에서 명확하게 평가되었다. 무뇌회증에서는 엽이 구분되지 않았고, 뇌고랑이 없고 두껍고 매끄러운 뇌이랑이 하나의 엽으로 되어 있었다. 분열뇌증에서는 분열틈을 중심으로 여러 뇌이랑이 바퀴모양을 형성하고, 넓은 뇌이랑을 가지고 있었다. 일측성 거대뇌증에서는 병변측 대뇌반구가 커져 있었고, 두껍고 넓은 뇌이랑을 가지고 있었다. 선천성 양측 실비안주위 증후군에서는 섬피질이 노출되어 있었고, 병변 부위의 뇌이랑은 두꺼워져 있었다. 국소적 뇌피질이형성증에서는 균일하지 않은 톱니 모양이나 두껍고 커진 뇌이랑이 보였다. 이중 피질 증후군에서는 뇌이랑과 뇌고랑의 이상소견은 보이지 않았다. 결론 : 뇌피질이형성증 환자에서 3차원 뇌표면연출영상은 비정상적인 뇌피질의 뇌이랑과 뇌고랑 의 모양을 평가할 수 있고 정확한 병변의 위치를 평가하는 데 유용하다. 뇌표면연출영상은 수술 전 계획을 세우는 데 유용한 정보를 제공한다.

Keywords

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