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Submitted
September 26, 2019
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April 15, 2020
Published
June 21, 2020
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Abstract

Our report is intended to analyze the specificity of certain magnetic resonance patterns that occur in imaging of neuronal-glial tumors associated with epilepsy in children.

Materials and methods: 33 children suffered from neuronal-glial tumors associated with symptomatic epilepsy (aged from 5 months to 17 years) were examined and treated within 2007-2017 years; prospective follow-up lasted from 1 to 8 years. MRI was performed by means of an apparatus with magnetic field induction of 1.5 and 3.0 Tesla before and after surgery. High resolution MRI (MRI HR) scan was applied in accordance with the epileptic scanning protocol. Anesthesia included methods of sevoflurane sedation.

Results: Dysembryoplastic neuroepithelial tumors (DNETs) confirmed histopathologically were revealed in 18 children; gangliogliomas (GGs) were revealed in 15 children. Histological analysis revealed the evidence of both DNET and GG in one tumor site in 2 patients. Six patients showed histopathologically confirmed dual pathology and focal cortical dysplasia FCD IIIb.

Verification of the neoplastic process on MRI results was complicated in 12 patients. Twenty one (21) patients showed the specific signs of tumors to be of neuronal-glial origin as described in literature; a cortical localization, a “triangular” shape, a “comet tail” symptom, and a “soup bubble” pattern.

Based on tractography (DTI) and fractionally anisotropy (FA) the paths displacement without the distraction of fibers integrity was observed in 4 patients with DNET and 2 patients with GG.

Peritumoral hyperintensity of the signal, the abnormality of gray-white differentiation and cortical organization let us suggest combination with dual pathology in 9 patients.

One case of DNET and four cases of GGs turned out to be contract positive. The localization was predominantly temporal. Reliable signs of a neoplastic process in the differential diagnosis were contrast enhancement and continued growth manifested in the adjacent bone tissue remodeling. However, in some cases, differentiation of DNETs / GGs /FCD IIb having a number of similar MRI signs was not possible until a histological diagnosis was made.

Keywords

neuronal-glial tumors drug-resistant epilepsy neuroimaging

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Copyright (c) 2020 Varis Khalilov, Alexey Kholin, Nikolay Zavadenko, Natalia Medvedeva, Khava Gazdieva

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How to Cite
Khalilov, V., Kholin, A., Zavadenko, N., Medvedeva, N., & Gazdieva, K. (2020). Neuroimaging patterns of neuronal-glial tumors associated with focal epilepsy in children. Journal of the International Child Neurology Association, 1(1). https://doi.org/10.17724/jicna.2020.119
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