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Frontal lobe gray matter heterotopia in pediatric patient

Case Study
de Kok, Wendy Philips Healthcare Philips Global
de Kort, Gerard Utrecht, University Medical Center Netherlands

Patient history:

A 5-year-old girl presented with severe seizures. An MR-examination was performed in the University Medical Center Utrecht, the Netherlands. The patient was sedated.

MR examination:

A comprehensive brain examination was performed. Images were acquired in three orthogonal directions and in various contrast weightings.

 

The MR-examination included T1W_SE in the sagittal plane, DUAL_SE in the axial plane and T2W_FLAIR in the coronal plane. Subsequently, a T1-weighted 3D TFE sequence was acquired with isotropic voxels. MPR reconstructions were created from this dataset.

Diffusion tensor imaging was also acquired, again with small isotropic voxels. Fractional anisotropy maps were created.

 

Contrast agent was administered, after which a T1-weighted 3D FFE sequence was acquired, this to detect possible contrast enhancement.

MR images and interpretation:

DUAL_SE axial First TE 30 ms, second TE 100 ms, to optimize T2-weighted contrast.T1W_SE sagittal T1-weighted sequence, optimized for speed. Scan time less than 1:30 min.T2W_FLAIR coronal Very long TR, TI and TE (11.000/2600/140) in FLAIR sequence to optimize T2-weighted contrast.
DUAL_SE axial
T1W_SE sagittal
T2W_FLAIR coronal
First TE 30 ms, second TE 100 ms, to optimize T2-weighted contrast.
T1-weighted sequence, optimized for speed. Scan time less than 1:30 min.
Very long TR, TI and TE (11.000/2600/140) in FLAIR sequence to optimize T2-weighted contrast.

 

Images were acquired in three orthogonal directions and in different contrast weightings. Full brain coverage is provided in these sequences.

All images clearly show thickening of the gray matter in the left frontal lobe.

 

 

T1W_3D_TFE MPR reconstruction from coronal dataset. Isotropic voxels.Diffusion tensor imaging Trace image from 15 diffusion directions. Isotropic voxels 2x2x2 mm.FA map Fractional anisotropy map from DTI dataset.
T1W_3D_TFE
Diffusion tensor imaging
FA map
MPR reconstruction from coronal dataset. Isotropic voxels.
Trace image from 15 diffusion directions. Isotropic voxels 2x2x2 mm.
Fractional anisotropy map from DTI dataset.

 

A T1-weighted 3D TFE sequence was acquired. The scan provides full brain coverage with high spatial resolution and isotropic voxels and very high T1-weighted contrast between gray and white matter. The data was acquired in the coronal plane and axial reformats were created. These reformats do clearly show frontal lobe gray matter heterotopia and cortical dysplasia in the left hemisphere.

 

Single-shot diffusion tensor imaging was also acquired. SENSE was used to reduce echo train length. The corresponding FA maps reveal the affected gray matter.

 

Finally, T1-weighted 3D FFE sequence was acquired after contrast injection. Contrast enhancement was not detected.

Impact of Achieva 1.5T imaging:

Freewave acquisition system allows use of 8-channel SENSE Head coil. This coil provides very good signal-to-noise ratio, even in sequences with high spatial resolution.

 

CLEAR homogeneity correction is used in all scans.

 

SENSE is used to reduce echo train length in single shot diffusion tensor imaging. It reduces susceptibility related distortions and reduces blurring.



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Jul 5, 2005

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Case Study
Achieva 1.5T
Release 1
Nova, Nova Dual, Pulsar
Brain, Neuro, Pediatric
 

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