Rauch Maximilian, Lachner Karsten, Frickel Lea, Lauer Monika, Adenauer Simon Jonas, Neuhaus Elisabeth, Hattingen Elke, Porto Luciana
Institute for Neuroradiology, Johann Wolfgang Goethe-University, Theodor Stern Kai 7, 60590, Frankfurt am Main, Germany.
Department of Radiology, Helios Klinikum Bonn/Rhein-Sieg, Von-Hompesch-Straße 1, 53123, Bonn, Germany.
Clin Neuroradiol. 2025 Mar;35(1):87-93. doi: 10.1007/s00062-024-01457-5. Epub 2024 Sep 13.
Polymicrogyria (PMG) is a cortical malformation frequently associated with epilepsy. Our aim was to investigate the frequency and conspicuity of enlarged perivascular spaces (EPVS) underneath dysplastic cortex as a potentially underrecognized feature of PMG in pediatric and adolescent patients undergoing clinical magnetic resonance imaging (MRI).
We analyzed data from 28 pediatric and adolescent patients with PMG and a matched control group, ranging in age from 2 days to 21 years, who underwent MRI at 1.5T or 3T. T2-weighted MR images were examined for the presence of EPVS underneath the dysplastic cortex. The quantity of EPVS was graded from 0 to 4 (0: none, 1: < 10, 2: 11-20, 3: 21-40, 4: > 40 EPVS). We then compared the presence and quantity of EPVS to the matched controls in terms of total EPVS scores, and EPVS scores underneath the dysplastsic cortex depending on the age groups, the localization of PMG, and the MRI field strength.
In 23/28 (82%) PMG patients, EPVS spatially related to the dysplastic cortex were identified. EPVS scores were significantly higher in PMG patients compared to controls, independent from age or PMG location. No significant differences were observed in EPVS scores in patients examined at 1.5T compared to those examined at 3T.
EPVS underneath the dysplastic cortex were identified in 82% of patients. EPVS may serve as an important clue for PMG and a marker for cortical malformation.
多小脑回畸形（PMG）是一种常与癫痫相关的皮质发育畸形。我们的目的是研究在接受临床磁共振成像（MRI）的儿科和青少年患者中，发育异常皮质下扩大的血管周围间隙（EPVS）的频率和显著程度，这是PMG一个可能未被充分认识的特征。
我们分析了28例患有PMG的儿科和青少年患者以及一个匹配对照组的数据，年龄范围从2天至21岁，他们接受了1.5T或3T的MRI检查。在T2加权磁共振图像上检查发育异常皮质下是否存在EPVS。EPVS的数量从0到4进行分级（0：无，1：<10，2：11 - 20，3：21 - 40，4：>40个EPVS）。然后我们根据总EPVS评分以及根据年龄组、PMG的定位和MRI场强，比较发育异常皮质下的EPVS评分中，PMG患者与匹配对照组中EPVS的存在情况和数量。
在23/28（82%）的PMG患者中，发现了与发育异常皮质在空间上相关的EPVS。与对照组相比，PMG患者的EPVS评分显著更高，与年龄或PMG位置无关。在1.5T检查的患者与在3T检查的患者之间，EPVS评分未观察到显著差异。
在82%的患者中发现了发育异常皮质下的EPVS。EPVS可能是PMG的一个重要线索以及皮质发育畸形的一个标志物。
