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<meta name="DC.Title" content="Morphologic Characteristics of Subcortical Heterotopia: MR Imaging Study" />
<meta name="DC.Date" content="2000-02-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Gray matter heterotopia have been divided into three groups based on clinical and imaging characteristics: subependymal, subcortical, and band heterotopia. Nonetheless, subcortical heterotopia can have variable morphologic findings. The purpose of this study was to perform a morphologic analysis of a series of cases of subcortical heterotopia based on MR images, to correlate the morphologic appearance with clinical characteristics, and to speculate about the embryologic implications of our results.

METHODS: The MR imaging studies and clinical records of 24 patients with subcortical heterotopia were retrospectively reviewed. The morphologic findings of the heterotopia were recorded along with presence and type of associated malformations. These results were correlated with available data on development and neurologic status.

RESULTS: Analysis revealed that, in six cases, the heterotopia were composed exclusively of multiple nodules, in 13, they appeared primarily as curvilinear ribbons of cortex extending into the white matter, and in five, they had deep nodular regions with curvilinear areas more peripherally. All of the curvilinear regions were contiguous with the cerebral cortex in at least two locations. In eight cases, curvilinear heterotopia contained curvilinear areas of flow void that were thought to be blood vessels; in 10, they contained fluid resembling CSF. No difference in developmental or neurologic manifestations was noted among patients with heterotopia of different morphologic appearances.

CONCLUSION: Subcortical heterotopia can have nodular or curvilinear morphologic appearances. Although no difference was found in the clinical conditions of the patients with differing morphologic appearances, additional analysis of these patients or studies of animal models of these malformations may further our understanding of normal and abnormal brain development." />
<meta name="DC.Contributor" content="A. James Barkovich" />
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<meta name="citation_title" content="Morphologic Characteristics of Subcortical Heterotopia: MR Imaging Study" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;i&gt;BACKGROUND AND PURPOSE:&lt;/i&gt; Gray matter heterotopia have been divided into three groups based on clinical and imaging characteristics: subependymal, subcortical, and band heterotopia. Nonetheless, subcortical heterotopia can have variable morphologic findings. The purpose of this study was to perform a morphologic analysis of a series of cases of subcortical heterotopia based on MR images, to correlate the morphologic appearance with clinical characteristics, and to speculate about the embryologic implications of our results.&lt;/p&gt;&lt;p&gt;&lt;i&gt;METHODS:&lt;/i&gt; The MR imaging studies and clinical records of 24 patients with subcortical heterotopia were retrospectively reviewed. The morphologic findings of the heterotopia were recorded along with presence and type of associated malformations. These results were correlated with available data on development and neurologic status.&lt;/p&gt;&lt;p&gt;&lt;i&gt;RESULTS:&lt;/i&gt; Analysis revealed that, in six cases, the heterotopia were composed exclusively of multiple nodules, in 13, they appeared primarily as curvilinear ribbons of cortex extending into the white matter, and in five, they had deep nodular regions with curvilinear areas more peripherally. All of the curvilinear regions were contiguous with the cerebral cortex in at least two locations. In eight cases, curvilinear heterotopia contained curvilinear areas of flow void that were thought to be blood vessels; in 10, they contained fluid resembling CSF. No difference in developmental or neurologic manifestations was noted among patients with heterotopia of different morphologic appearances.&lt;/p&gt;&lt;p&gt;&lt;i&gt;CONCLUSION:&lt;/i&gt; Subcortical heterotopia can have nodular or curvilinear morphologic appearances. Although no difference was found in the clinical conditions of the patients with differing morphologic appearances, additional analysis of these patients or studies of animal models of these malformations may further our understanding of normal and abnormal brain development.&lt;/p&gt;" />
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<meta name="twitter:title" content="Morphologic Characteristics of Subcortical Heterotopia: MR Imaging Study" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Gray matter heterotopia have been divided into three groups based on clinical and imaging characteristics: subependymal, subcortical, and band heterotopia. Nonetheless, subcortical heterotopia can have variable morphologic findings. The purpose of this study was to perform a morphologic analysis of a series of cases of subcortical heterotopia based on MR images, to correlate the morphologic appearance with clinical characteristics, and to speculate about the embryologic implications of our results.

METHODS: The MR imaging studies and clinical records of 24 patients with subcortical heterotopia were retrospectively reviewed. The morphologic findings of the heterotopia were recorded along with presence and type of associated malformations. These results were correlated with available data on development and neurologic status.

RESULTS: Analysis revealed that, in six cases, the heterotopia were composed exclusively of multiple nodules, in 13, they appeared primarily as curvilinear ribbons of cortex extending into the white matter, and in five, they had deep nodular regions with curvilinear areas more peripherally. All of the curvilinear regions were contiguous with the cerebral cortex in at least two locations. In eight cases, curvilinear heterotopia contained curvilinear areas of flow void that were thought to be blood vessels; in 10, they contained fluid resembling CSF. No difference in developmental or neurologic manifestations was noted among patients with heterotopia of different morphologic appearances.

CONCLUSION: Subcortical heterotopia can have nodular or curvilinear morphologic appearances. Although no difference was found in the clinical conditions of the patients with differing morphologic appearances, additional analysis of these patients or studies of animal models of these malformations may further our understanding of normal and abnormal brain development." />
<meta name="og-title" property="og:title" content="Morphologic Characteristics of Subcortical Heterotopia: MR Imaging Study" />
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<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Gray matter heterotopia have been divided into three groups based on clinical and imaging characteristics: subependymal, subcortical, and band heterotopia. Nonetheless, subcortical heterotopia can have variable morphologic findings. The purpose of this study was to perform a morphologic analysis of a series of cases of subcortical heterotopia based on MR images, to correlate the morphologic appearance with clinical characteristics, and to speculate about the embryologic implications of our results.

METHODS: The MR imaging studies and clinical records of 24 patients with subcortical heterotopia were retrospectively reviewed. The morphologic findings of the heterotopia were recorded along with presence and type of associated malformations. These results were correlated with available data on development and neurologic status.

RESULTS: Analysis revealed that, in six cases, the heterotopia were composed exclusively of multiple nodules, in 13, they appeared primarily as curvilinear ribbons of cortex extending into the white matter, and in five, they had deep nodular regions with curvilinear areas more peripherally. All of the curvilinear regions were contiguous with the cerebral cortex in at least two locations. In eight cases, curvilinear heterotopia contained curvilinear areas of flow void that were thought to be blood vessels; in 10, they contained fluid resembling CSF. No difference in developmental or neurologic manifestations was noted among patients with heterotopia of different morphologic appearances.

CONCLUSION: Subcortical heterotopia can have nodular or curvilinear morphologic appearances. Although no difference was found in the clinical conditions of the patients with differing morphologic appearances, additional analysis of these patients or studies of animal models of these malformations may further our understanding of normal and abnormal brain development." />
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<div id="hw-article-author-popups-top-node-11478--6219882996" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A. James Barkovich </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology, Section of Neuroradiology, University of California, San Francisco, San Francisco, CA.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BJames%2BBarkovich%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Barkovich%20AJ&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BJames%2BBarkovich%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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    <div class="elements-frag-data highwire-markup" id="fig-data"><div id="fig-data-figures" class="group frag-figure"><div class="fig-data-title-jump clearfix"><h3 class="fig-data-group-title">Figures</h3><div class="fig-data-jump-links"></div></div><div class="item-list"><ul class="fig-data-list clearfix" id="fragments-fig"><li class="first"><div class="element-fig-data clearfix figure-caption"><div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="fig-expansion " id="F1"><span class="highwire-journal-article-marker-start"></span><div class="highwire-figure"><div class="fig-inline-img-wrapper"><div class="fig-inline-img"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F1.large.jpg?width=800&amp;height=600&amp;carousel=1" title="FIG 1.&#x2003;Nodular subcortical heterotopia with callosal agenesis.   A, Axial spin-echo 3000/60 (TR/TE) image of a 1-month-old patient shows multiple nodular heterotopia (arrows) lining the frontal horn of the right lateral ventricle and extending into the center of the frontal white matter. The right hemisphere is reduced in size. The overlying cortex is thin and has a reduced number of sulci. The sulci present are abnormally shallow. The corpus callosum is agenetic. B, Coronal spin-echo 600/16 image of the same patient shows the same findings." class="highwire-fragment fragment-images colorbox-load" rel="gallery-fragment-images-1827274231" data-figure-caption="&lt;div class=&quot;highwire-markup&quot;&gt;&lt;div xmlns=&quot;http://www.w3.org/1999/xhtml&quot;&gt;FIG 1.&#x2003;Nodular subcortical heterotopia with callosal agenesis.   &lt;em&gt;A,&lt;/em&gt; Axial spin-echo 3000/60 (TR/TE) image of a 1-month-old patient shows multiple nodular heterotopia (&lt;em&gt;arrows&lt;/em&gt;) lining the frontal horn of the right lateral ventricle and extending into the center of the frontal white matter. The right hemisphere is reduced in size. The overlying cortex is thin and has a reduced number of sulci. The sulci present are abnormally shallow. The corpus callosum is agenetic. &lt;em&gt;B,&lt;/em&gt; Coronal spin-echo 600/16 image of the same patient shows the same findings.&lt;/div&gt;&lt;/div&gt;" data-icon-position="" data-hide-link-title="0"><span class="hw-responsive-img"><img class="highwire-fragment fragment-image lazyload" alt="Figure1" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" data-src="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F1.medium.gif" width="650" height="335"/><noscript><img class="highwire-fragment fragment-image" alt="Figure1" src="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F1.medium.gif" width="650" height="335"/></noscript></span></a></div></div><ul class="highwire-figure-links inline"><li class="download-fig first"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F1.large.jpg?download=true" class="highwire-figure-link highwire-figure-link-download" title="Download Figure1" data-icon-position="" data-hide-link-title="0">Download figure</a></li><li class="new-tab"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F1.large.jpg" class="highwire-figure-link highwire-figure-link-newtab" target="_blank" data-icon-position="" data-hide-link-title="0">Open in new tab</a></li><li class="download-ppt last"><a href="/highwire/powerpoint/35783" class="highwire-figure-link highwire-figure-link-ppt" data-icon-position="" data-hide-link-title="0">Download powerpoint</a></li></ul></div><div class="fig-caption" xmlns:xhtml="http://www.w3.org/1999/xhtml"><p id="p-22">FIG 1. Nodular subcortical heterotopia with callosal agenesis.  </p><p id="p-23"><em>A,</em> Axial spin-echo 3000/60 (TR/TE) image of a 1-month-old patient shows multiple nodular heterotopia (<em>arrows</em>) lining the frontal horn of the right lateral ventricle and extending into the center of the frontal white matter. The right hemisphere is reduced in size. The overlying cortex is thin and has a reduced number of sulci. The sulci present are abnormally shallow. The corpus callosum is agenetic.</p><p id="p-24"><em>B,</em> Coronal spin-echo 600/16 image of the same patient shows the same findings.</p><div class="sb-div caption-clear"></div></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div></div></li><li><div class="element-fig-data clearfix figure-caption"><div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="fig-expansion " id="F2"><span class="highwire-journal-article-marker-start"></span><div class="highwire-figure"><div class="fig-inline-img-wrapper"><div class="fig-inline-img"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F2.large.jpg?width=800&amp;height=600&amp;carousel=1" title="FIG 2.&#x2003;Curvilinear subcortical heterotopia.   A, Axial spin-echo (2500/80) image shows curvilinear subcortical heterotopia (white arrowheads) emanating from the pericallosal sulci bilaterally. Note the curvilinear flow voids (black arrowheads) of blood vessels extending into the heterotopia from the sulci. B, Axial spin-echo (2500/80) image obtained at a higher level shows the heterotopia (large white arrows) extending all the way back to the occipital poles. Note the CSF (small white arrows) and the blood vessels (small black arrows) coursing within the heterotopia. The cerebral cortex is thin, and the sulci are shallow. C, Axial spin-echo (2500/80) image obtained at a still higher level shows the contiguity of the curvilinear heterotopia (large white arrows) from the frontal to the occipital lobes. Note that CSF (small white arrows) and blood vessels (small black arrow) are present, even at the center of the heterotopia." class="highwire-fragment fragment-images colorbox-load" rel="gallery-fragment-images-1827274231" data-figure-caption="&lt;div class=&quot;highwire-markup&quot;&gt;&lt;div xmlns=&quot;http://www.w3.org/1999/xhtml&quot;&gt;FIG 2.&#x2003;Curvilinear subcortical heterotopia.   &lt;em&gt;A,&lt;/em&gt; Axial spin-echo (2500/80) image shows curvilinear subcortical heterotopia (&lt;em&gt;white arrowheads&lt;/em&gt;) emanating from the pericallosal sulci bilaterally. Note the curvilinear flow voids (&lt;em&gt;black arrowheads&lt;/em&gt;) of blood vessels extending into the heterotopia from the sulci. &lt;em&gt;B,&lt;/em&gt; Axial spin-echo (2500/80) image obtained at a higher level shows the heterotopia (&lt;em&gt;large white arrows&lt;/em&gt;) extending all the way back to the occipital poles. Note the CSF (&lt;em&gt;small white arrows&lt;/em&gt;) and the blood vessels (&lt;em&gt;small black arrows&lt;/em&gt;) coursing within the heterotopia. The cerebral cortex is thin, and the sulci are shallow. &lt;em&gt;C,&lt;/em&gt; Axial spin-echo (2500/80) image obtained at a still higher level shows the contiguity of the curvilinear heterotopia (&lt;em&gt;large white arrows&lt;/em&gt;) from the frontal to the occipital lobes. Note that CSF (&lt;em&gt;small white arrows&lt;/em&gt;) and blood vessels (&lt;em&gt;small black arrow&lt;/em&gt;) are present, even at the center of the heterotopia.&lt;/div&gt;&lt;/div&gt;" data-icon-position="" data-hide-link-title="0"><span class="hw-responsive-img"><img class="highwire-fragment fragment-image lazyload" alt="Figure2" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" data-src="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F2.medium.gif" width="650" height="234"/><noscript><img class="highwire-fragment fragment-image" alt="Figure2" src="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F2.medium.gif" width="650" height="234"/></noscript></span></a></div></div><ul class="highwire-figure-links inline"><li class="download-fig first"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F2.large.jpg?download=true" class="highwire-figure-link highwire-figure-link-download" title="Download Figure2" data-icon-position="" data-hide-link-title="0">Download figure</a></li><li class="new-tab"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F2.large.jpg" class="highwire-figure-link highwire-figure-link-newtab" target="_blank" data-icon-position="" data-hide-link-title="0">Open in new tab</a></li><li class="download-ppt last"><a href="/highwire/powerpoint/35707" class="highwire-figure-link highwire-figure-link-ppt" data-icon-position="" data-hide-link-title="0">Download powerpoint</a></li></ul></div><div class="fig-caption" xmlns:xhtml="http://www.w3.org/1999/xhtml"><p id="p-25">FIG 2. Curvilinear subcortical heterotopia.  </p><p id="p-26"><em>A,</em> Axial spin-echo (2500/80) image shows curvilinear subcortical heterotopia (<em>white arrowheads</em>) emanating from the pericallosal sulci bilaterally. Note the curvilinear flow voids (<em>black arrowheads</em>) of blood vessels extending into the heterotopia from the sulci.</p><p id="p-27"><em>B,</em> Axial spin-echo (2500/80) image obtained at a higher level shows the heterotopia (<em>large white arrows</em>) extending all the way back to the occipital poles. Note the CSF (<em>small white arrows</em>) and the blood vessels (<em>small black arrows</em>) coursing within the heterotopia. The cerebral cortex is thin, and the sulci are shallow.</p><p id="p-28"><em>C,</em> Axial spin-echo (2500/80) image obtained at a still higher level shows the contiguity of the curvilinear heterotopia (<em>large white arrows</em>) from the frontal to the occipital lobes. Note that CSF (<em>small white arrows</em>) and blood vessels (<em>small black arrow</em>) are present, even at the center of the heterotopia.</p><div class="sb-div caption-clear"></div></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div></div></li><li class="last"><div class="element-fig-data clearfix figure-caption"><div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="fig-expansion " id="F3"><span class="highwire-journal-article-marker-start"></span><div class="highwire-figure"><div class="fig-inline-img-wrapper"><div class="fig-inline-img"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F3.large.jpg?width=800&amp;height=600&amp;carousel=1" title="FIG 3.&#x2003;Mixed curvilinear/nodular subcortical heterotopia.   A, Axial spin-echo (2500/80) image shows nodular heterotopia (white arrows) in the periventricular white matter bilaterally. No cortical connection is seen at this level. B, Axial spin-echo (2500/80) image obtained at a higher level shows that the heterotopia (white arrows) are contiguous with the cortex bilaterally." class="highwire-fragment fragment-images colorbox-load" rel="gallery-fragment-images-1827274231" data-figure-caption="&lt;div class=&quot;highwire-markup&quot;&gt;&lt;div xmlns=&quot;http://www.w3.org/1999/xhtml&quot;&gt;FIG 3.&#x2003;Mixed curvilinear/nodular subcortical heterotopia.   &lt;em&gt;A,&lt;/em&gt; Axial spin-echo (2500/80) image shows nodular heterotopia (&lt;em&gt;white arrows&lt;/em&gt;) in the periventricular white matter bilaterally. No cortical connection is seen at this level. &lt;em&gt;B,&lt;/em&gt; Axial spin-echo (2500/80) image obtained at a higher level shows that the heterotopia (&lt;em&gt;white arrows&lt;/em&gt;) are contiguous with the cortex bilaterally.&lt;/div&gt;&lt;/div&gt;" data-icon-position="" data-hide-link-title="0"><span class="hw-responsive-img"><img class="highwire-fragment fragment-image lazyload" alt="Figure3" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" data-src="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F3.medium.gif" width="650" height="346"/><noscript><img class="highwire-fragment fragment-image" alt="Figure3" src="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F3.medium.gif" width="650" height="346"/></noscript></span></a></div></div><ul class="highwire-figure-links inline"><li class="download-fig first"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F3.large.jpg?download=true" class="highwire-figure-link highwire-figure-link-download" title="Download Figure3" data-icon-position="" data-hide-link-title="0">Download figure</a></li><li class="new-tab"><a href="http://ajnr-stage2.stage.highwire.org/content/ajnr/21/2/290/F3.large.jpg" class="highwire-figure-link highwire-figure-link-newtab" target="_blank" data-icon-position="" data-hide-link-title="0">Open in new tab</a></li><li class="download-ppt last"><a href="/highwire/powerpoint/35738" class="highwire-figure-link highwire-figure-link-ppt" data-icon-position="" data-hide-link-title="0">Download powerpoint</a></li></ul></div><div class="fig-caption" xmlns:xhtml="http://www.w3.org/1999/xhtml"><p id="p-29">FIG 3. Mixed curvilinear/nodular subcortical heterotopia.  </p><p id="p-30"><em>A,</em> Axial spin-echo (2500/80) image shows nodular heterotopia (<em>white arrows</em>) in the periventricular white matter bilaterally. No cortical connection is seen at this level.</p><p id="p-31"><em>B,</em> Axial spin-echo (2500/80) image obtained at a higher level shows that the heterotopia (<em>white arrows</em>) are contiguous with the cortex bilaterally.</p><div class="sb-div caption-clear"></div></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div></div></li></ul></div></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 21</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 2 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Feb 2000 </div></div>
      
      
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