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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">epilepsia</journal-id><journal-title-group><journal-title xml:lang="en">Epilepsy and paroxysmal conditions</journal-title><trans-title-group xml:lang="ru"><trans-title>Эпилепсия и пароксизмальные состояния</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2077-8333</issn><issn pub-type="epub">2311-4088</issn><publisher><publisher-name>IRBIS LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17749/2077-8333.2020.12.1.36-50</article-id><article-id custom-type="elpub" pub-id-type="custom">epilepsia-517</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group></article-categories><title-group><article-title>MRI diagnosis of cortical dysplasia in the immature brain</article-title><trans-title-group xml:lang="ru"><trans-title>МРТ-диагностика кортикальных дисплазий в незрелом мозге</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4468-7660</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Полянская</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Polyanskaya</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>старший лаборант кафедры неврологии, нейрохирургии и медицинской генетики педиатрического факультета, врач-рентгенолог отделения лучевой диагностики РДКБ,</p><p>ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>MD, Senior Laboratory Assistant, Department of Neurology, Neurosurgery and Medical Genetics, Faculty of Pediatrics, Radiologist, Department of Diagnostic Radiology, Children’s Clinical Hospital</p><p>1 Ostrovityanova Str., Moscow 117997, Russia</p></bio><email xlink:type="simple">m.polyan@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Демушкина</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Demushkina</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., врач-рентгенолог отделения лучевой диагностики РДКБ,</p><p>ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>MD, PhD, Radiologist, Department of Diagnostic Radiology, Children’s Clinical Hospital,</p><p>1 Ostrovityanova Str., Moscow 117997, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Костылев</surname><given-names>Ф. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kostylev</surname><given-names>F. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач-рентгенолог отделения лучевой диагностики РДКБ,</p><p>ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>MD, Radiologist, Department of Diagnostic Radiology, Children’s Clinical Hospital,</p><p>1 Ostrovityanova Str., Moscow 117997, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8782-3007</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Курбанова</surname><given-names>Ф. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kurbanova</surname><given-names>F. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач-рентгенолог отделения лучевой диагностики РДКБ,</p><p>ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>MD, Radiologist, Department of Diagnostic Radiology, Children’s Clinical Hospital,</p><p>1 Ostrovityanova Str., Moscow 117997, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Васильев</surname><given-names>И. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Vasilyev</surname><given-names>I. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач-нейрохирург отделения нейрохирургии РДКБ,</p><p>ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>MD, Neurosurgeon, Department of Neurosurgery, Children’s Clinical Hospital,</p><p>1 Ostrovityanova Str., Moscow 117997, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чадаев</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Chadaev</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., врач-невролог отделения нейрохирургии РДКБ,</p><p>ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>MD, PhD, Neurologist, Department of Neurosurgery, Children’s Clinical Hospital,</p><p>1 Ostrovityanova Str., Moscow 117997, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0103-7422</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Заваденко</surname><given-names>Н. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Zavadenko</surname><given-names>N. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор, заведующий кафедрой неврологии, нейрохирургии и медицинской генетики педиатрического факультета,</p><p>ул. Островитянова, д. 1, Москва 117997, Россия</p><p>РИНЦ Author ID: 86405; Scopus Author ID: 7004071775</p></bio><bio xml:lang="en"><p>MD, Dr Sci Med, Professor &amp; Head, Department of Neurology, Neurosurgery and Medical Genetics, Faculty of Pediatrics,</p><p>1 Ostrovityanova Str., Moscow 117997, Russia</p><p>RSCI Author ID: 86405; Scopus Author ID: 7004071775</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8097-7919</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Алиханов</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Alikhanov</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор, заведующий отделением лучевой диагностики РДКБ,</p><p>ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>MD, Dr Sci Med, Professor &amp; Head, Department of Diagnostic Radiology, Children’s Clinical Hospital,</p><p>1 Ostrovityanova Str., Moscow 117997, Russia</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное автономное образовательное учреждение высшего образования «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pirogov Russian National Research Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>15</day><month>04</month><year>2020</year></pub-date><volume>12</volume><issue>1</issue><fpage>36</fpage><lpage>50</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Polyanskaya M.V., Demushkina A.A., Kostylev F.A., Kurbanova F.A., Vasilyev I.G., Chadaev V.A., Zavadenko N.N., Alikhanov A.A., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Полянская М.В., Демушкина А.А., Костылев Ф.А., Курбанова Ф.А., Васильев И.Г., Чадаев В.А., Заваденко Н.Н., Алиханов А.А.</copyright-holder><copyright-holder xml:lang="en">Polyanskaya M.V., Demushkina A.A., Kostylev F.A., Kurbanova F.A., Vasilyev I.G., Chadaev V.A., Zavadenko N.N., Alikhanov A.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.epilepsia.su/jour/article/view/517">https://www.epilepsia.su/jour/article/view/517</self-uri><abstract><sec><title>Introduction</title><p>Introduction. Cortical dysplasias (CDs) encompass a wide variety of disorders that in most cases lead to epilepsy, especially in infants and young children. MRI diagnosis of CDs is a major part of presurgical examination of pediatric patients with resistant focal epilepsy.</p></sec><sec><title>Aim</title><p>Aim. To identify MR markers of CD in the immature brain and develop an MRI protocol for early diagnosis of CDs.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. Children aged &lt;2 y.o. (total 128) diagnosed with focal epilepsy were examined over 2017-2019. All MRI scans were performed using the GE 3 T system (General Electric, USA) in the standard MR sequences including T2WI FSE, T1 SE, FLAIR, DWI, SWAN, and FSPGR BRAVO supported with anesthesiological assistance. Аll patients were divided into 3 groups according to the degree of brain maturity; of those, 28 patients had MR signs of CD.</p></sec><sec><title>Results</title><p>Results. The rate of detection of small-size cortical malformations, such as nodular heterotopies or focal cortical dysplasias was significantly higher in groups of patients whose brains (according to MR images) were at the infantile or adult phases of myelination. In children with the isointensive phase myelination, only large cortical dysplasias could be identified. In the first phase, the focal malformations had low amplitude signals in T2-weighted images and high amplitude signals in T1, unlike those in adult patients. In the isointensive phase, the quality of visualization was significantly reduced and provided poor diagnostic information.</p></sec><sec><title>Conclusion</title><p>Conclusion. The results confirm the diagnostic significance of early (before age of 5 months) MRI testing in cases with suspected CD-associated focal epilepsy. However, at the period between 5 and 12 months of age, MR imaging was ineffective for CD diagnosing. Later, in the period from 12 to 15 months, the MRI ability to identify the CDs gradually increased. We consider the standard T2 weighted images with high TR values, the most effective MR modality for diagnosing CDs in young children.</p></sec></abstract><trans-abstract xml:lang="ru"><sec><title>Введение</title><p>Введение. Кортикальные дисплазии (КД) включают обширный спектр нарушений процесса формирования коры головного мозга и в большом проценте случаев становятся причиной развития эпилепсии у детей. Визуализация КД крайне важна при определении потенциальной эффективности хирургической тактики лечения. Однако у детей раннего возраста МР-диагностика дисплазий сопряжена с определенными трудностями и имеет ряд особенностей ввиду вариабельной миелинизации, характерной структуры серого и белого вещества мозга, а также сложностей, связанных с проведением МРТ.</p><p>Цель – демонстрация МР-характеристик основных видов кортикальных дисплазий в незрелом мозге у детей с фокальной эпилепсией и разработка оптимизированных подходов к их как можно более раннему выявлению.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. Были оценены результаты МР-исследований детей первых двух лет жизни с фармакорезистентной фокальной эпилепсией, выполненных в отделении лучевой диагностики Российской детской клинической больницы ФГАОУ ВО «Российского национального исследовательского медицинского университета имени Н. И. Пирогова» за период с 2017 по 2019 г. Всего было обследовано 128 пациентов, из них 28 с кортикальными дисплазиями; все пациенты были распределены на три группы по степени зрелости мозга. Исследования проводились на магнитно-резонансном томографе с индукцией магнитного поля 3 Тесла.</p></sec><sec><title>Результаты</title><p>Результаты. Идентификация небольших по размеру кортикальных мальформаций, таких как узловые гетеротопии или негрубые фокальные кортикальные дисплазии, была значительно выше в группах пациентов, МР-картина мозга которых соответствовала инфантильной и взрослой фазам миелинизации, тогда как среди пациентов, распределенных в группу изоинтенсивной фазы, были выявлены только грубые кортикальные пороки. При этом визуализационные паттерны очаговых мальформаций в первую фазу преимущественно характеризовались ин- версивной картиной относительно общепринятых МР-маркеров дисплазий – низким сигналом на Т2-взвешенных изображениях и изо- или гиперинтенсивным сигналом в Т1. В изоинтенсивную фазу визуализация структурного поражения значительно снижалась, отмечалась стертость, стушеванность МР-симптомов на фоне скудной демаркации серого и белого вещества, микширующей кортикальную дисплазию.</p></sec><sec><title>Заключение</title><p>Заключение. Проведенное исследование позволило обозначить основные МР-маркеры кортикальных дисплазий в незрелом мозге – утолщение кортикальной пластинки, нечеткость дифференциации между корой и белым веществом, извращение рисунка борозд, а также релаксационные сдвиги в участках пораженной коры с диаметрально противоположным МР-сигналом, чем у взрослых – пониженным в Т2-взвешенном изображении и высоким в Т1. Предпочтительным периодом для оптимальной идентификации кортикальных дисплазий выбран возраст до 5 мес., соответствующий инфантильной фазе миелинизации. Неблагоприятной фазой для визуализации большинства дисплазий, особенно фокальных и не крупных, определен возраст от 5 до 15 мес. После 15 мес. способность к распознаванию кортикальных дисплазий возвращается и к 24 мес. соответствует стандартам визуализации их у взрослых пациентов. Наиболее эффективным инструментом МР визуализации кортикальных дисплазий у детей раннего возраста мы считаем стандартные Т2-взвешенные изображения с высоким временем TR.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>Кортикальные дисплазии</kwd><kwd>незрелый мозг</kwd><kwd>миелинизация</kwd><kwd>МРТ высокого разрешения</kwd><kwd>хирургическое лечение эпилепсии</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Brain MRI</kwd><kwd>epilepsy surgery</kwd><kwd>epileptogenic lesion</kwd><kwd>myelination</kwd><kwd>malformations of cortical development</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Leventer R.J., Phelan E.M., Coleman L.T., Kean M.J., Jackson G.D., Harvey A.S. 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