Published ahead of print on January 31, 2008
doi: 10.3174/ajnr.A0919
Aberrant Midsagittal Fiber Tracts in Patients with Hemimegalencephaly
N. Satoa,
M. Otaa,
A. Yagishitac,
Y. Mikid,
T. Takahashia,
Y. Adachia,
Y. Nakatae,
K. Sugaib and
M. Sasakib
a Department of Radiology, Musashi Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
b Department of Child Neurology, Musashi Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
c Department of Neuroradiology, Tokyo Metropolitan Neurological Hospital, Fucyu, Tokyo, Japan
d Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University School of Medicine, Kyoto, Japan
e Department of Radiology, Tokyo University School of Medicine, Bunkyo-ku, Tokyo, Japan
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Fig 1. A 19-year-old female patient with left hemimegalencephaly evaluated in the retrospective analysis. A, T2-weighted image shows increased width (arrows) between the 2 anterior horns due to a white matter–intensity structure (arrowhead). B and C, The white matter–intensity structure appears to extend posteriorly and to pass through the bodies of the lateral ventricles beneath the corpus callosum (arrow).
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Fig 2. An 8-year-old boy with left hemimegalencephaly (case 1). A, Coronal T2-weighted inversion recovery image shows a white matter–intensity structure between the 2 anterior horns (arrow). B, Axial T2-weighted image shows a midsagittal bandlike structure between the bodies of the 2 lateral ventricles (arrow). It appears to cross from anterior-left to posterior-right. C, Coronal T2-weighted inversion recovery image. The left fornix (arrowhead) is normal, while the right one (arrow) is thick. D–F, 2D coronal (D), 2D axial (E), and 2D coronal (F) views on fiber tract (FT) reconstruction. The images correspond to A, B, and C, respectively. Aberrant midsagittal fibers penetrate the midsagittal bandlike structures shown in A–C. G and H, 3D superior (G) and 3D right lateral (H) views on FT reconstruction. The fibers run between the 2 frontal lobes and the contralateral occipital and parietal lobes. The main fibers pass through the right crus of the fornix.
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Fig 3. An 11-year-old boy with right hemimegalencephaly (case 2). A, Coronal T2-weighted inversion recovery image shows markedly increased width between the 2 anterior horns occupied by a white matter–intensity structure (arrows). B, Axial T2-weighted image demonstrates an abnormal white matter–intensity bandlike structure between the 2 lateral ventricles (arrow), which separates in the posterior portion and runs a course similar to that of the cruces of the fornices (arrowheads). C, Coronal T2-weighted inversion recovery image posterior to that in A also detects bilateral marked thickening of the cruces of the fornices (arrows). D–F, 2D coronal (D), 2D axial (E), and 2D coronal (F) views on FT reconstruction. These images correspond to A, B, and C, respectively. Aberrant midsagittal fibers penetrate the midsagittal abnormal white matter–intensity structures shown in A–C. G–I, 3D superior (G), 3D left lateral superior (H), and 3D left lateral (I) views on FT reconstruction. Aberrant massive fibers connect the bilateral frontal and occipital and parietal lobes passing through abnormal midsagittal structures. They are dominant ipsilaterally.
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