Achiriloaie Adina, Deisch Jeremy, Boling Warren, Bannout Firas
Loma Linda University Medical Center (AA), Department of Radiology, Loma Linda, CA; Loma Linda University Medical Center (JD), Department of Pathology, Loma Linda, CA; Loma Linda University Medical Center (WB), Department of Neurosurgery, Loma Linda, CA; and Loma Linda University Medical Center (FB), Department of Neurology, Loma Linda, CA.
Neurol Clin Pract. 2021 Oct;11(5):445-451. doi: 10.1212/CPJ.0000000000001019.
Brain MRI findings of focal cortical dysplasia (FCD) can undergo dramatic changes over time, which may be related to long-term epilepsy or a combination of histopathologic changes that necessitate further investigation.
We describe 2 cases of FCD type IIb that initially displayed inconspicuous findings on MRI, however progressed to obvious signal changes on subsequent MRI 10-17 years later. Pathologic analysis indicates that the interval changes are likely attributed to reactive astrogliosis and diffuse parenchymal rarefaction. A few case reports and case series showing similar MRI changes have been described in the literature, the majority in pediatric patients. The adult cases we present add to the scientific evidence of these changes occurring in the adult population.
Our observations lead to several clinical suggestions, including closer interval follow-up imaging for nonlesional cases, the addition of postprocessing imaging methods, earlier surgical intervention, and meticulous surgical planning.
局灶性皮质发育不良（FCD）的脑部MRI表现可能随时间发生显著变化，这可能与长期癫痫或需要进一步研究的组织病理学变化组合有关。
我们描述了2例IIb型FCD病例，其最初在MRI上表现不明显，但在10 - 17年后的后续MRI上进展为明显的信号变化。病理分析表明，间隔期变化可能归因于反应性星形胶质细胞增生和弥漫性实质稀疏。文献中已描述了一些显示类似MRI变化的病例报告和病例系列，大多数为儿科患者。我们呈现的成人病例增加了这些变化在成人人群中发生的科学证据。
我们的观察结果得出了一些临床建议，包括对无病变病例进行更密切的间隔期随访成像、增加后处理成像方法、更早的手术干预以及精心的手术规划。
