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The Changing MR Imaging Appearance of Polymicrogyria: A Consequence of Myelination

Jun-ichi Takanashia and A. James Barkovicha

a From the Neuroradiology Section, Department of Radiology, University of California San Francisco, San Francisco, CA



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  		FIG 1. Patient 2 (aged 2 months), with bilateral frontal and sylvian PMG.

T2-weighted image shows pattern 1: abnormal cortex with a small, fine, and undulating appearance in the insulae and orbital surfaces of the frontal lobes (arrowheads). The cortical thickness was 4 mm.



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  		FIG 2. Patient 12 (aged 3 years), with left hemispheric PMG.

T2-weighted image shows pattern 2: abnormally thick sylvian and perisylvian cortex (7 mm at the left sylvian cortex) with a bumpy appearance at the surface and the cortical-white matter junction.



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  		FIG 3. Patient 4, with right hemispheric PMG.

A and B, Images obtained when the patient was 3 months old. T2-weighted image (A) shows pattern 1: 4-mm-thick cortex in the parietal lobe (arrowheads). T1-weighted image (B) shows pattern 2: 5-mm thickness in the same region.

C and D, Images obtained when the patient was 11 months old. T2-weighted image (C) at the parietal lobe shows pattern 1: 4-mm thickness and a 2-mm-thick layer of T2 prolongation between the cortex and myelinated white matter (arrowheads). T1-weighted image (D) shows pattern 2: 6-mm thickness of the same cortex.

E and F, Images obtained when the patient was 2 years old. In the parietal lobe (arrowheads), T2- (E) and T1-weighted (F) images show pattern 2: 6-mm thickness. The T1-weighted image (F) shows pattern 2 in the frontal lobe: 5-mm thickness. Conversely, the T2- weighted image (E) reveals pattern 1 in the frontal lobe: 3-mm thickness with subjacent layer of T2 prolongation.



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  		FIG 4. Diagrammatic representation of the cerebral cortex in four-layered PMG. (Reprinted from Fig 210, R. Excourolle and J. Poirier, Manual of Basic Neuropathology. 2nd ed. [1978] with permission of Elsevier Science.)





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X