Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Epilepsia. 2023 Jun;64(6):1605-1611. doi: 10.1111/epi.17604. Epub 2023 Apr 12.
Previous studies using advanced magnetic resonance imaging (MRI) techniques have documented abnormal transmantle bands connecting ectopic nodules to overlying cortex in patients with periventricular nodular heterotopia (PNH). We describe a similar finding using conventional MRI techniques.
Patients were identified by means of a full-text search of radiological reports. All scanning was performed using conventional sequences at 3 Tesla (3T). Scans were reviewed by three neuroradiologists, and we characterized imaging features based on type of PNH and cortical irregularities associated with the transmantle band.
A total 57 PNH patients were reviewed, of whom 41 demonstrated a "transmantle band" connecting the nodule to the overlying cortex. One or more periventricular heterotopic nodules was present in all 41 patients-this was bilateral in 29 of 41 (71%) and unilateral in the remaining 29%. In many cases there was more than one such band, and in some cases this band was nodular. In 19 of the cases, the cortex to which the band connected was abnormal, showing thinning in 4 cases, thickening in 5 cases, and polymicrogyria in another 10.
The transmantle band can be seen frequently in both unilateral and bilateral cases of PNH and can be visualized with conventional 3T MRI sequences. The band highlights the underlying neuronal migration issues at play in the pathogenesis of this disorder, but its underlying role in the complex, patient-specific epileptogenic networks in this cohort has yet to be determined and warrants further investigation.
先前使用先进的磁共振成像（MRI）技术的研究记录了脑室周围结节性异位（PNH）患者中异常的跨膜带将异位结节与上覆皮质连接起来。我们使用常规 MRI 技术描述了类似的发现。
通过放射报告的全文搜索确定患者。所有扫描均在 3 特斯拉（3T）下使用常规序列进行。由三位神经放射科医生对扫描进行了审查，并根据 PNH 的类型和与跨膜带相关的皮质不规则性来描述成像特征。
共回顾了 57 例 PNH 患者，其中 41 例显示出连接结节与上覆皮质的“跨膜带”。所有 41 例患者均存在一个或多个脑室周围异位结节-29 例（71%）为双侧，其余 29 例为单侧。在许多情况下，存在不止一条这样的带，在某些情况下，该带是结节状的。在 19 例中，与带相连的皮质异常，4 例皮质变薄，5 例皮质增厚，另 10 例皮质多微小脑回。
跨膜带在单侧和双侧 PNH 中均可频繁看到，并且可以用常规的 3T MRI 序列进行可视化。该带突出了在这种疾病发病机制中起作用的潜在神经元迁移问题，但它在该队列中复杂的、特定于患者的致痫性网络中的潜在作用尚未确定，值得进一步研究。
