Gri Cevher Heterotopisi Bulunan Pediatrik Hastaların Manyetik Rezonans Görüntüleme Bulguları ve Eşlik Eden Malformasyonların Değerlendirilmesi

Yıl 2022, Cilt: 17 Sayı: 3, 146 - 151, 02.11.2022

Yeşim Eroğlu , Serpil Ağlamış

https://doi.org/10.17517/ksutfd.1023811

Öz

Özet

Amaç: Çalışmanın amacı, pediatrik hastalarda saptanan gri cevher heterotopilerini manyetik rezonans görüntüleme bulgularına göre sınıflandırmak ve eşlik eden serebral malformasyonları tanımlamaktır.

Gereç ve Yöntemler: Ocak 2012-Haziran 2020 tarihleri arasında beyin manyetik rezonans görüntülemelerinde heterotopi tespit ettiğimiz tüm çocuk hastaların görüntüleri retrospektif olarak değerlendirildi. Heterotopinin tipi, yeri ve eşlik eden serebral anomaliler incelendi.

Bulgular: Çalışmaya gri cevher heterotopisi bulunan ortalama yaşı 7.80±4.53 yıl (2-16 yıl) olan 22’si erkek, 20’si kız toplam 42 hasta dahil edildi. Hastaların 33’ünde (%78.6) subependimal, 7’sinde (%16.7) subkortikal ve 2’sinde (%4.7) bant heterotopi saptandı. Yirmi dört hastanın epilepsisi vardı.

Sonuç: Çalışmamıza göre pediatrik hastalarda en sık subependimal heterotopi görüldü. Subependimal heterotopiler en sık lateral ventriküllerin trigon kısmında yerleşmişti. Subkortikal heterotopilerin tümü frontalde ve unifokal yerleşimli idi. Bant heterotopiler bilateral serebral hemisferde subkortikal bölgede simetrik yerleşimli idi. Başlıca eşlik eden serebral anomaliler Chiari 2 malformasyonu ve korpus kallosum agenezisi idi. Pediatrik hastalarda hasta yönetimi açısından heterotopinin tipinin ve ilişkili serebral anomalilerin tanımlanması önemlidir.

Anahtar Kelimeler

Gri cevher heterotopisi, Pediatri, Manyetik rezonans görüntüleme, Subependimal, Malformasyon

Magnetic Resonance Imaging Findings and Accompanying Malformations in Pediatric Patients with Gray Matter Heterotopia

Öz

Abstract

Objective: The aim of the study is to classify gray matter heterotopias detected in pediatric patients according to magnetic resonance imaging findings and to define the accompanying cerebral malformations.

Material and Methods: Images of all pediatric patients who were detected to have heterotopia in brain magnetic resonance imaging between January 2012 and June 2020 were retrospectively evaluated. The type, location of heterotopia, and accompanying cerebral anomalies were analyzed.

Results: A total of 42 patients, 22 male, and 20 female, with a mean age of 7.80±4.53 years (2-16 years) with gray matter heterotopia were included in the study. Of the patients 33 (78.6%) had subependymal, 7 (16.7%) had subcortical, and 2 (4.7%) had band heterotopia. Twenty-four patients had epilepsy.

Conclusion: According to our study, subependymal heterotopia was most common in pediatric patients. The subependymal heterotopias were most commonly located in the trigon region of the lateral ventricles. All of the subcortical heterotopies were located in the frontal and unifocal. Band heterotopias were located symmetrically in the subcortical region of the bilateral cerebral hemispheres. The main accompanying anomalies were Chiari II malformation, and corpus callosum agenesis. Defining the type of heterotopia and associated anomalies in pediatric patients is important for patient management.

Anahtar Kelimeler

Gray Matter Heterotopia, Pediatrics, Magnetic resonance imaging, Subependymal, Malformation

Kaynakça

• Barkovich AJ, Kuzniecky RI. Gray matter heterotopia. Neurology. 2000;55(11):1603-1608.
• Battal B, Ince S, Akgun V, Kocaoglu M, Ozcan E, Tasar M. Malformations of cortical development: 3T magnetic resonance imaging features. World J Radiol. 2015;7(10):329-335.
• Abdel Razek AA, Kandell AY, Elsorogy LG, Elmongy A, Basett AA. Disorders of cortical formation: MR imaging features. AJNR Am J Neuroradiol. 2009;30(1):4-11.
• Fry AE, Kerr MP, Gibbon F, Turnpenny PD, Hamandi K, Stoodley N et al. Neuropsychiatric disease in patients with periventricular heterotopia. J Neuropsychiatry Clin Neurosci. 2013;25(1):26-31.
• Zając-Mnich M, Kostkiewicz A, Guz W, Dziurzyńska-Białek E, Solińska A, Stopa J et al. Clinical and morphological aspects of gray matter heterotopia type developmental malformations. Pol J Radiol. 2014;79:502-507.
• Barkovich AJ, Kuzniecky RI, Jackson GD, Guerrini R, Dobyns WB. A developmental and genetic classification for malformations of cortical development. Neurology. 2005;65(12):1873-1887.
• Raza HK, Chen H, Chansysouphanthong T, Zhang Z, Hua F, Ye X et al. The clinical and imaging features of gray matter heterotopia: A clinical analysis on 15 patients. Neurol Sci. 2019;40(3):489-494.
• Fauser S, Schulze-Bonhage A, Honegger J, Carmona H, Huppertz HJ, Pantazis G et al. Focal cortical dysplasias: surgical outcome in 67 patients in relation to histological subtypes and dual pathology. Brain. 2004;127:2406-2418.
• Barkovich AJ, Kuzniecky RI, Jackson GD, Guerrini R, Dobyns WB. Classification system for malformations of cortical development: Update 2001. Neurology. 2001;57(12):2168-2178.
• Barkovich AJ, Guerrini R, Kuzniecky RI, Jackson GD, Dobyns WB. A developmental and genetic classification for malformations of cortical development: Update 2012. Brain. 2012;135:1348-1369.
• Di Nora A, Costanza G, Pizzo F, Oliva CF, Di Mari A, Greco F et al. Gray matter heterotopia: clinical and neuroimaging report on 22 children. Acta Neurol Belg. 2022;122(1):153-162.
• Aghakhani Y, Kinay D, Gotman J, Soualmi L, Andermann F, Olivier A et al. The role of periventricular nodular heterotopia in epileptogenesis. Brain. 2005;128:641-651.
• Guerrini R, Dobyns WB. Bilateral periventricular nodular heterotopia with mental retardation and frontonasal malformation. Neurology. 1998;51(2):499-503.
• Pridmore S, McInerney G, Rybak M, Archer S. Psychotic disorder NOS with heterotopia. J Pychiatr Intensive Care. 2007;2:118-121.
• Mitchell LA, Simon EM, Filly RA, Barkovich AJ. Antenatal diagnosis of subependymal heterotopia. AJNR Am J Neuroradiol. 2000;21(2):296-300.
• Bourgeois JA, Nisenbaum J, Drexler KG, Dobbins KM, Hall MJ. A case of subcortical grey matter heterotopia presenting as bipolar disorder. Compr Psychiatry. 1992;33(6):407-410.
• Oegema R, Barkovich AJ, Mancini GMS, Guerrini R, Dobyns WB. Subcortical heterotopic gray matter brain malformations: Classification study of 107 individuals. Neurology. 2019;93(14):e1360-e1373.
• Guerrini R, Parrini E. Neuronal migration disorders. Neurobiol Dis. 2010;38(2):154-166.
• Donkol RH, Moghazy KM, Abolenin A. Assessment of gray matter heterotopia by magnetic resonance imaging. World J Radiol. 2012;4(3):90-96.
• Hung PC, Wang HS, Chou ML, Lin KL, Hsieh MY, Wong AM. Clinical and neuroimaging findings in children with gray matter heterotopias: A single institution experience of 36 patients. Eur J Paediatr Neurol. 2016;20(5):732-737.
• Felker MV, Walker LM, Sokol DK, Edwards-Brown M, Chang BS. Early cognitive and behavioral problems in children with nodular heterotopia. Epilepsy Behav. 2011;22(3):523-526.
• Filippi CG, Maxwell AW, Watts R. Magnetic resonance diffusion tensor imaging metrics in perilesional white matter among children with periventricular nodular gray matter heterotopia. Pediatr Radiol. 2013;43(9):1196-1203.