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AJNR - American Journal of Neuroradiology

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Advanced MR Imaging of Cortical Dysplasia with or without Neoplasm: A Report of Two Cases

Jay J. Pillai^a, Richard B. Hessler^b, Jerry D. Allison^a, Yong D. Park^c, Mark R. Lee^d and Tom Lavin^a

^a Department of Radiology, the Medical College of Georgia, Augusta, GA
^b Department of Pathology, the Medical College of Georgia, Augusta, GA
^c Department of Neurology, the Medical College of Georgia, Augusta, GA
^d Department of Neurosurgery, the Medical College of Georgia, Augusta, GA

View larger version (78K): [in a new window]   FIG 1. Coronal view FLAIR images from case 1 (left) and case 2 (right) (9999/119/1 [TR/TE/NEX]) show hyperintensity in the ganglioglioma within the right occipital lobe in case 1 and isointensity to normal gray matter in the benign cortical dysplasia in case 2.

View larger version (62K): [in a new window]   FIG 2. MR spectra from case 1 (1500/270; number of signals acquired, 128), obtained by using a 2 x 2 x 2 cm voxel centered within abnormal right occipital tissue (left) and within normal left occipital tissue (right), show reduced NAA/Cr and NAA/Cho ratios in the abnormal right occipital tissue compared with the normal left occipital tissue.

View larger version (77K): [in a new window]   FIG 3. ADC maps (4000/100/2) from case 2 (left) and case 1 (right). Mean ADC measurements within regions of interest encompassing the dysplastic right occipital cortex and normal contralateral homologous region in case 1 are displayed. Note the hyperintensity (indicative of increased ADC values) in the right occipital cortex in case 1 and the isointensity in case 2.

View larger version (157K): [in a new window]   FIG 4. A binucleate neoplastic neuron (arrow) is seen in the ganglioglioma (hematoxylin and eosin; original magnification, x400) in case 1.

View larger version (57K): [in a new window]   FIG 5. Case 2 spectra (1500/270/128), obtained by using a 2 x 2 x 2 cm voxel size (left, right occipital lobe voxel; right, left occipital lobe voxel), show reduced NAA/Cr and NAA/Cho ratios in the voxel placed within the abnormal right occipital tissue compared with those obtained in the contralateral normal occipital lobe. However, the degree of the relative reduction is less than that seen in case 1.

View larger version (145K): [in a new window]   FIG 6. Neurofilament immunohistochemistry shows the enlarged, atypical neurons characteristic of severe cortical dysplasia with neuronal cytoskeletal abnormalities (neurofilament stain with hematoxylin counterstain; original magnification, x400) in case 2.