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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/epi.par.con.2020.025</article-id><article-id custom-type="elpub" pub-id-type="custom">epilepsia-555</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>The role of susceptibility-weighted imaging (SWI) in neuroimaging in children with focal epilepsy</article-title><trans-title-group xml:lang="ru"><trans-title>Возможности режима SWI в магнито-резонансной нейровизуализации у детей с фокальной эпилепсией</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>Полянская Майя Владимировна – врач-рентгенолог отделения лучевой диагностики РДКБ, старший лаборант кафедры неврологии, нейрохирургии и медицинской генетики имени академика Л. О. Бадаляна педиатрического факультета, ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>Maiya V. Polyanskaya – MD, Senior Laboratory Assistant, Department of Neurology, Neurosurgery and Medical Genetics, Faculty of Pediatrics; Radiologist, Department of Diagnostic Radiology, Children’s Clinical Hospital, 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>Демушкина Алиса Анатольевна – к. м.н., врач-рентгенолог отделения лучевой диагностики РДКБ, ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>Alisa A. Demushkina – MD, PhD (Medical Sciences), Radiologist, Department of Diagnostic Radiology, Children’s Clinical Hospital, 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>Костылев Федор Александрович – врач-рентгенолог отделения лучевой диагностики РДКБ, ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>Fedor A. Kostylev – MD, Radiologist, Department of Diagnostic Radiology, Children’s Clinical Hospital, 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>Васильев Игорь Германович – врач-нейрохирург отделения нейрохирургии РДКБ, ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>Igor G. Vasilyev – MD, Neurosurgeon, Department of Neurosurgery, Children’s Clinical Hospital, 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>Чадаев Виктор Алексеевич – к. м.н., врач-невролог отделения нейрохирургии РДКБ, ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>Viktor A. Chadaev – MD, PhD (Medical Sciences), Neurologist, Department of Neurosurgery, Children’s Clinical Hospital, 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>Заваденко Николай Николаевич – д. м.н., проф., зав. кафедрой неврологии, нейрохирургии и медицинской генетики имени академика Л. О. Бадаляна педиатрического факультета, Scopus Author ID: 7004071775, РИНЦ SPIN-код: 86405, ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>Nikolai N. Zavadenko – MD, PhD, Professor &amp; Head, Department of Neurology, Neurosurgery and Medical Genetics, Faculty of Pediatrics, Scopus Author ID: 7004071775, RSCI SPIN-code: 86405, 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/0000-0001-8097-7919</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>Алиханов Алихан Амруллахович – д. м.н., профессор, зав. отделением лучевой диагностики РДКБ, ул. Островитянова, д. 1, Москва 117997, Россия</p></bio><bio xml:lang="en"><p>Alikhan A. Alikhanov – MD, PhD (Medical Sciences), Professor &amp; Head, Department of Diagnostic Radiology, Children’s Clinical Hospital, 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 бюджетное образовательное учреждение высшего образования «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России</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>10</day><month>09</month><year>2020</year></pub-date><volume>12</volume><issue>2</issue><fpage>105</fpage><lpage>116</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Polyanskaya M.V., Demushkina A.A., Kostylev 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., 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., 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/555">https://www.epilepsia.su/jour/article/view/555</self-uri><abstract><sec><title>Aim</title><p>Aim. To approve of diagnostic effectiveness of SWAN (SWI) images in revealing of calcium containing epileptogenic substrates in children with resistant focal epilepsy.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. The results of MRI in children with refractory focal epilepsy obtained in the Radiology Department of the Russian State Children Hospital in the period from 2018 to 2020 were observed retrospectively. High-resolution epileptological MR protocol used for investigation of 67 children. SWAN was applied in all cases for identification of calcium containing epileptogenic substrates, including cavernomas, DVA syndrome, cortical gangliogliomas, Sturge-Weber syndrome and tuberous sclerosis complex. All images were received by using MRI 3T 750 W Discovery GE.</p></sec><sec><title>Results</title><p>Results. In 17 cases (25%) SWAN provided important diagnostic information about the nature of the of epileptogenic lesion, its prevalence and borders. Additional earlier invisible structural changes were revealed in 2 cases of SWS and 1 cases of FCD; and in 13 cases SWAN gave us possibility to avoid CT for approving calcium in epileptogenic focus.</p></sec><sec><title>Conclusion</title><p>Conclusion. We believe that adding SWAN in to the epileptological MR protocol is the necessary step for optimizing calcium and blood degradation products identification in the structure of potential epileptogenic focuses. Moreover, it would be very effective instrument for differential diagnosis of cerebral structural changes, specifying its etiology and, hence, would have influence on the therapeutic tactic and surgical strategy in children with focal epilepsy.</p></sec></abstract><trans-abstract xml:lang="ru"><sec><title>Введение</title><p>Введение. Взвешенная по магнитной восприимчивости импульсная последовательность (ИП) магнитно-резонансной (МР) томографии SWI (SWAN) зарекомендовала себя как отличный инструмент верификации широкого спектра потенциально эпилептогенных субстратов, который включает сосудистые дисплазии, опухоли, поражения при некоторых факоматозах, а также у пациентов, перенесших интракраниальное кровоизлияние, нейроинфекцию или паразитарную инвазию.</p></sec><sec><title>Цель</title><p>Цель. Демонстрация диагностических возможностей ИП SWI (SWAN) в рамках эпилептического МР-протокола у детей с фокальной эпилепсией.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. Оценены результаты МР-исследований детей с фармакорезистентной фокальной эпилепсией, выполненных за период с 2018 по 2020 г. Всего по эпилептическому МР-протоколу с высоким разрешением были обследованы 67 пациентов, ИП SWAN выполняли всем пациентам, при этом кальцификация, отложения гемосидерина, а также венозные сосуды, содержащие дезоксигенированную кровь, определяли в виде зон снижения сигнала. Исследования проводили на МР-томографе с индукцией магнитного поля 3 Тесла.</p></sec><sec><title>Результаты</title><p>Результаты. В 17 (25%) случаях при анализе SWI (SWAN) получена важная диагностическая информация о природе поражения, его распространенности и границах. Дополнительные структурные изменения на SWI (SWAN) обнаружены у двух пациентов с синдромом Штурге-Вебера (СШВ) и у одного пациента с фокальной кортикальной дисплазией (ФКД), в 13 случаях наличие изображений SWI (SWAN) исключило необходимость проведения уточняющего КТ-исследования.</p></sec><sec><title>Выводы</title><p>Выводы. Включение ИП SWI (SWAN), чувствительной к гемосидерину и кальцию, в рутинный эпилептический протокол является обязательным условием качественной нейровизуализации у детей с фармакорезистентной эпилепсией, поскольку данная ИП существенно улучшает диагностику и позволяет обнаружить субтильные эпилептогенные субстраты, которые могут быть неочевидными при анализе других последовательностей. SWI (SWAN) может быть полезна при проведении дифференциальной диагностики эпилептогенных поражений и уточнении этиологии структурного нарушения и, соответственно, может влиять на тактику лечения, а также помогает избежать проведения дополнительных КТ-исследований, тем самым нивелируя риски, связанные с лучевой нагрузкой.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>хирургическое лечение эпилепсии</kwd><kwd>эпилептогенные субстраты</kwd><kwd>гемосидерин</kwd><kwd>МРТ-изображения</kwd><kwd>взвешенные по магнитной восприимчивости</kwd></kwd-group><kwd-group xml:lang="en"><kwd>epileptogenic lesion</kwd><kwd>drug-resistant epilepsy</kwd><kwd>epilepsy surgery</kwd><kwd>MRI</kwd><kwd>SWI</kwd><kwd>hemosiderin</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">Bernasconi A., Cendes F., Theodore W. H., Gill R. S., Koepp M. J., Hogan R. E., Jackson G. 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