TY - JOUR T1 - Optimizing the Detection of Subtle Insular Lesions on MRI When Insular Epilepsy Is Suspected JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. DO - 10.3174/ajnr.A6143 AU - J. Blustajn AU - S. Krystal AU - D. Taussig AU - S. Ferrand-Sorbets AU - G. Dorfmüller AU - M. Fohlen Y1 - 2019/08/01 UR - http://www.ajnr.org/content/early/2019/08/01/ajnr.A6143.abstract N2 - SUMMARY: Insular epilepsy is underdiagnosed and accounts for a number of failed operations. Identifying insular target lesions on MR imaging can help guide intracranial electroencephalography and improve the outcome of surgery. In this study, we present a novel method of exploring the insular region for subtle lesions on 3D MR imaging by MPR postprocessing of slices in oblique reference planes. Using this method, we retrospectively reviewed presurgical MRIs that were initially considered to have normal findings in 7 pediatric patients with intractable insular epilepsy. Insular epilepsy was confirmed in these patients on stereo-electroencephalography and histopathology. The MPR postprocessing method we describe helped detect subtle insular lesions in all 7 patients.FCDfocal cortical dysplasiaSEEGstereo-electroencephalography ER -