A novel technique of detecting MRI-negative lesion in focal symptomatic epilepsy: Intraoperative ShearWave Elastography

作者：Chan Huan Wee^*; Pressler Ronit; Uff Christopher; Gunny Roxanna; St Piers Kelly; Cross Helen; Bamber Jeffrey; Dorward Neil; Harkness William; Chakraborty Aabir

来源：Epilepsia, 2014, 55(4): E30-E33.

DOI：10.1111/epi.12562

• Intraoperative ultrasound
• Focal epilepsy
• Shear wave
• Elastography
• Cortical dysplasia

Focal symptomatic epilepsy is the most common form of epilepsy that can often be cured with surgery. A small proportion of patients with focal symptomatic epilepsy do not have identifiable lesions on magnetic resonance imaging (MRI). The most common pathology in this group is type II focal cortical dysplasia (FCD), which is a subtype of malformative brain lesion associated with medication-resistant epilepsy. We present a patient with MRI-negative focal symptomatic epilepsy who underwent invasive electrode recordings. At the time of surgery, a novel ultrasound-based technique called ShearWave Elastography (SWE) was performed. A 0.5cc lesion was demonstrated on SWE but was absent on B-mode ultrasound and 3-T MRI. Electroencephalography (EEG), positron emission tomography (PET), and magnetoencephalography (MEG) scans demonstrated an abnormality in the right frontal region. On the basis of this finding, a depth electrode was implanted into the lesion. Surgical resection and histology confirmed the lesion to be type IIb FCD.
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• 出版日期2014-4