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<meta name="DC.Title" content="Ultra-High-Field Targeted Imaging of Focal Cortical Dysplasia: The Intracortical Black Line Sign in Type IIb" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6298" />
<meta name="DC.Date" content="2019-12-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Conventional MR imaging has limitations in detecting focal cortical dysplasia. We assessed the added value of 7T in patients with histologically proved focal cortical dysplasia to highlight correlations between neuropathology and ultra-high-field imaging.

MATERIALS AND METHODS: Between 2013 and 2019, we performed a standardized 7T MR imaging protocol in patients with drug-resistant focal epilepsy. We focused on 12 patients in whom postsurgical histopathology revealed focal cortical dysplasia and explored the diagnostic yield of preoperative 7T versus 1.5/3T MR imaging and the correlations of imaging findings with histopathology. We also assessed the relationship between epilepsy surgery outcome and the completeness of surgical removal of the MR imaging–visible structural abnormality.

RESULTS: We observed clear abnormalities in 10/12 patients using 7T versus 9/12 revealed by 1.5/3T MR imaging. In patients with focal cortical dysplasia I, 7T MR imaging did not disclose morphologic abnormalities ( n  = 0/2). In patients with focal cortical dysplasia II, 7T uncovered morphologic signs that were not visible on clinical imaging in 1 patient with focal cortical dysplasia IIa ( n  = 1/4) and in all those with focal cortical dysplasia IIb ( n  = 6/6). T2*WI provided the highest added value, disclosing a peculiar intracortical hypointense band (black line) in 5/6 patients with focal cortical dysplasia IIb. The complete removal of the black line was associated with good postsurgical outcome ( n  = 4/5), while its incomplete removal yielded unsatisfactory results ( n  = 1/5).

CONCLUSIONS: The high sensitivity of 7T T2*-weighted images provides an additional tool in defining potential morphologic markers of high epileptogenicity within the dysplastic tissue of focal cortical dysplasia IIb and will likely help to more precisely plan epilepsy surgery and explain surgical failures.

EEG
:   electroencephalography
FCD
:   focal cortical dysplasia
SWAN
:   susceptibility-weighted angiography" />
<meta name="DC.Contributor" content="E. Bartolini" />
<meta name="DC.Contributor" content="M. Cosottini" />
<meta name="DC.Contributor" content="M. Costagli" />
<meta name="DC.Contributor" content="C. Barba" />
<meta name="DC.Contributor" content="L. Tassi" />
<meta name="DC.Contributor" content="R. Spreafico" />
<meta name="DC.Contributor" content="R. Garbelli" />
<meta name="DC.Contributor" content="L. Biagi" />
<meta name="DC.Contributor" content="A. Buccoliero" />
<meta name="DC.Contributor" content="F. Giordano" />
<meta name="DC.Contributor" content="R. Guerrini" />
<meta name="article:published_time" content="2019-12-01" />
<meta name="article:section" content="Pediatrics" />
<meta name="citation_title" content="Ultra-High-Field Targeted Imaging of Focal Cortical Dysplasia: The Intracortical Black Line Sign in Type IIb" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Conventional MR imaging has limitations in detecting focal cortical dysplasia. We assessed the added value of 7T in patients with histologically proved focal cortical dysplasia to highlight correlations between neuropathology and ultra-high-field imaging.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Between 2013 and 2019, we performed a standardized 7T MR imaging protocol in patients with drug-resistant focal epilepsy. We focused on 12 patients in whom postsurgical histopathology revealed focal cortical dysplasia and explored the diagnostic yield of preoperative 7T versus 1.5/3T MR imaging and the correlations of imaging findings with histopathology. We also assessed the relationship between epilepsy surgery outcome and the completeness of surgical removal of the MR imaging–visible structural abnormality.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;We observed clear abnormalities in 10/12 patients using 7T versus 9/12 revealed by 1.5/3T MR imaging. In patients with focal cortical dysplasia I, 7T MR imaging did not disclose morphologic abnormalities (&lt;i&gt;n&lt;/i&gt; = 0/2). In patients with focal cortical dysplasia II, 7T uncovered morphologic signs that were not visible on clinical imaging in 1 patient with focal cortical dysplasia IIa (&lt;i&gt;n&lt;/i&gt; = 1/4) and in all those with focal cortical dysplasia IIb (&lt;i&gt;n&lt;/i&gt; = 6/6). T2*WI provided the highest added value, disclosing a peculiar intracortical hypointense band (black line) in 5/6 patients with focal cortical dysplasia IIb. The complete removal of the black line was associated with good postsurgical outcome (&lt;i&gt;n&lt;/i&gt; = 4/5), while its incomplete removal yielded unsatisfactory results (&lt;i&gt;n&lt;/i&gt; = 1/5).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The high sensitivity of 7T T2*-weighted images provides an additional tool in defining potential morphologic markers of high epileptogenicity within the dysplastic tissue of focal cortical dysplasia IIb and will likely help to more precisely plan epilepsy surgery and explain surgical failures.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2019/12/01" />
<meta name="citation_mjid" content="ajnr;40/12/2137" />
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<meta name="citation_volume" content="40" />
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<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="Pediatrics" />
<meta name="citation_firstpage" content="2137" />
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<meta name="citation_author" content="E. Bartolini" />
<meta name="citation_author_institution" content="aFrom the Department of Pediatric Neurology (E.B., C.B., A.B., R. Guerrini)" />
<meta name="citation_author_institution" content="cNeurology Unit (E.B.), USL Centro Toscana, Nuovo Ospedale Santo Stefano, Prato, Italy" />
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<meta name="citation_author" content="M. Cosottini" />
<meta name="citation_author_institution" content="dDepartment of Translational Research and New Technologies in Medicine and Surgery (M. Cosottini), University of Pisa, Pisa, Italy" />
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<meta name="citation_author" content="M. Costagli" />
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<meta name="citation_author_institution" content="aFrom the Department of Pediatric Neurology (E.B., C.B., A.B., R. Guerrini)" />
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<meta name="twitter:title" content="Ultra-High-Field Targeted Imaging of Focal Cortical Dysplasia: The Intracortical Black Line Sign in Type IIb" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Conventional MR imaging has limitations in detecting focal cortical dysplasia. We assessed the added value of 7T in patients with histologically proved focal cortical dysplasia to highlight correlations between neuropathology and ultra-high-field imaging.

MATERIALS AND METHODS: Between 2013 and 2019, we performed a standardized 7T MR imaging protocol in patients with drug-resistant focal epilepsy. We focused on 12 patients in whom postsurgical histopathology revealed focal cortical dysplasia and explored the diagnostic yield of preoperative 7T versus 1.5/3T MR imaging and the correlations of imaging findings with histopathology. We also assessed the relationship between epilepsy surgery outcome and the completeness of surgical removal of the MR imaging–visible structural abnormality.

RESULTS: We observed clear abnormalities in 10/12 patients using 7T versus 9/12 revealed by 1.5/3T MR imaging. In patients with focal cortical dysplasia I, 7T MR imaging did not disclose morphologic abnormalities ( n  = 0/2). In patients with focal cortical dysplasia II, 7T uncovered morphologic signs that were not visible on clinical imaging in 1 patient with focal cortical dysplasia IIa ( n  = 1/4) and in all those with focal cortical dysplasia IIb ( n  = 6/6). T2*WI provided the highest added value, disclosing a peculiar intracortical hypointense band (black line) in 5/6 patients with focal cortical dysplasia IIb. The complete removal of the black line was associated with good postsurgical outcome ( n  = 4/5), while its incomplete removal yielded unsatisfactory results ( n  = 1/5).

CONCLUSIONS: The high sensitivity of 7T T2*-weighted images provides an additional tool in defining potential morphologic markers of high epileptogenicity within the dysplastic tissue of focal cortical dysplasia IIb and will likely help to more precisely plan epilepsy surgery and explain surgical failures.

EEG
:   electroencephalography
FCD
:   focal cortical dysplasia
SWAN
:   susceptibility-weighted angiography" />
<meta name="og-title" property="og:title" content="Ultra-High-Field Targeted Imaging of Focal Cortical Dysplasia: The Intracortical Black Line Sign in Type IIb" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/40/12/2137" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Conventional MR imaging has limitations in detecting focal cortical dysplasia. We assessed the added value of 7T in patients with histologically proved focal cortical dysplasia to highlight correlations between neuropathology and ultra-high-field imaging.

MATERIALS AND METHODS: Between 2013 and 2019, we performed a standardized 7T MR imaging protocol in patients with drug-resistant focal epilepsy. We focused on 12 patients in whom postsurgical histopathology revealed focal cortical dysplasia and explored the diagnostic yield of preoperative 7T versus 1.5/3T MR imaging and the correlations of imaging findings with histopathology. We also assessed the relationship between epilepsy surgery outcome and the completeness of surgical removal of the MR imaging–visible structural abnormality.

RESULTS: We observed clear abnormalities in 10/12 patients using 7T versus 9/12 revealed by 1.5/3T MR imaging. In patients with focal cortical dysplasia I, 7T MR imaging did not disclose morphologic abnormalities ( n  = 0/2). In patients with focal cortical dysplasia II, 7T uncovered morphologic signs that were not visible on clinical imaging in 1 patient with focal cortical dysplasia IIa ( n  = 1/4) and in all those with focal cortical dysplasia IIb ( n  = 6/6). T2*WI provided the highest added value, disclosing a peculiar intracortical hypointense band (black line) in 5/6 patients with focal cortical dysplasia IIb. The complete removal of the black line was associated with good postsurgical outcome ( n  = 4/5), while its incomplete removal yielded unsatisfactory results ( n  = 1/5).

CONCLUSIONS: The high sensitivity of 7T T2*-weighted images provides an additional tool in defining potential morphologic markers of high epileptogenicity within the dysplastic tissue of focal cortical dysplasia IIb and will likely help to more precisely plan epilepsy surgery and explain surgical failures.

EEG
:   electroencephalography
FCD
:   focal cortical dysplasia
SWAN
:   susceptibility-weighted angiography" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node71922--5" data-node-nid="71922" id="top-node-71922--6763159705" data-pisa="ajnr;40/12/2137" data-pisa-master="ajnr;ajnr.A6298" data-apath="/ajnr/40/12/2137.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Pediatrics</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Ultra-High-Field Targeted Imaging of Focal Cortical Dysplasia: The Intracortical Black Line Sign in Type IIb</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">E. Bartolini</span>, <span class="highwire-citation-author" data-delta="1">M. Cosottini</span>, <span class="highwire-citation-author" data-delta="2">M. Costagli</span>, <span class="highwire-citation-author" data-delta="3">C. Barba</span>, <span class="highwire-citation-author" data-delta="4">L. Tassi</span>, <span class="highwire-citation-author" data-delta="5">R. Spreafico</span>, <span class="highwire-citation-author" data-delta="6">R. Garbelli</span>, <span class="highwire-citation-author" data-delta="7">L. Biagi</span>, <span class="highwire-citation-author" data-delta="8">A. Buccoliero</span>, <span class="highwire-citation-author" data-delta="9">F. Giordano</span> and <span class="highwire-citation-author" data-delta="10">R. Guerrini</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">December 2019,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(12) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2137-2142; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6298 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-71922--6763159705" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">E. Bartolini </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 Pediatric Neurology (E.B., C.B., A.B., R. Guerrini)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Neurology Unit (E.B.), USL Centro Toscana, Nuovo Ospedale Santo Stefano, Prato, Italy</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=E.%2BBartolini%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=Bartolini%20E&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"><a href="/search/author1%3AE.%2BBartolini%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-5683-1941" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for E. Bartolini</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M. Cosottini </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Translational Research and New Technologies in Medicine and Surgery (M. Cosottini), University of Pisa, Pisa, Italy</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=M.%2BCosottini%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=Cosottini%20M&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"><a href="/search/author1%3AM.%2BCosottini%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-9400-6574" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Cosottini</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">M. Costagli </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>IMAGO7 Research Foundation (M. Costagli), Pisa, Italy</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=M.%2BCostagli%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=Costagli%20M&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"><a href="/search/author1%3AM.%2BCostagli%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-9073-1082" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Costagli</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">C. Barba </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 Pediatric Neurology (E.B., C.B., A.B., R. Guerrini)</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=C.%2BBarba%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=Barba%20C&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"><a href="/search/author1%3AC.%2BBarba%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-5445-5842" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Barba</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">L. Tassi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Epilepsy Surgery Centre C. Munari (L.T.), Ospedale Niguarda, Milano, Italy</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=L.%2BTassi%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=Tassi%20L&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"><a href="/search/author1%3AL.%2BTassi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-0632-7296" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Tassi</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">R. Spreafico </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>g</span>Clinical Epileptology and Experimental Neurophysiology Unit (R.S., R. Garbelli), Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologico C. Besta, Milano, Italy</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=R.%2BSpreafico%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=Spreafico%20R&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"><a href="/search/author1%3AR.%2BSpreafico%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6528-1240" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Spreafico</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">R. Garbelli </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>g</span>Clinical Epileptology and Experimental Neurophysiology Unit (R.S., R. Garbelli), Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologico C. Besta, Milano, Italy</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=R.%2BGarbelli%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=Garbelli%20R&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"><a href="/search/author1%3AR.%2BGarbelli%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6475-4974" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Garbelli</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">L. Biagi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>h</span>Istituto Di Ricovero e Cura a Carattere Scientifico Fondazione Stella Maris (L.B., R. Guerrini), Pisa, Italy.</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=L.%2BBiagi%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=Biagi%20L&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"><a href="/search/author1%3AL.%2BBiagi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2159-439X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Biagi</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">A. Buccoliero </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 Pediatric Neurology (E.B., C.B., A.B., R. Guerrini)</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.%2BBuccoliero%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=Buccoliero%20A&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"><a href="/search/author1%3AA.%2BBuccoliero%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7113-8387" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. 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Meyer-University of Florence, Florence, Italy</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=F.%2BGiordano%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=Giordano%20F&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"><a href="/search/author1%3AF.%2BGiordano%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8415-3236" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F. 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Guerrini), Pisa, Italy.</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=R.%2BGuerrini%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=Guerrini%20R&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"><a href="/search/author1%3AR.%2BGuerrini%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7272-7079" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Guerrini</a></li></ul></div></div></div>  </div>

  
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    <div class="messages highwire-corrections highwire-correction-type-correction"><h3 class="highwire-corrections-title">This article has a correction. Please see:</h3><ul class="highwire-corrections-list"><li class="relation-6901 first last"><a href="/content/41/9/E84" class="" data-icon-position="" data-hide-link-title="0">Erratum - September 01, 2020</a></li></ul></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-2"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-3"><strong>BACKGROUND AND PURPOSE:</strong> Conventional MR imaging has limitations in detecting focal cortical dysplasia. We assessed the added value of 7T in patients with histologically proved focal cortical dysplasia to highlight correlations between neuropathology and ultra-high-field imaging.</p></div><div id="sec-2" class="subsection"><p id="p-4"><strong>MATERIALS AND METHODS:</strong> Between 2013 and 2019, we performed a standardized 7T MR imaging protocol in patients with drug-resistant focal epilepsy. We focused on 12 patients in whom postsurgical histopathology revealed focal cortical dysplasia and explored the diagnostic yield of preoperative 7T versus 1.5/3T MR imaging and the correlations of imaging findings with histopathology. We also assessed the relationship between epilepsy surgery outcome and the completeness of surgical removal of the MR imaging–visible structural abnormality.</p></div><div id="sec-3" class="subsection"><p id="p-5"><strong>RESULTS:</strong> We observed clear abnormalities in 10/12 patients using 7T versus 9/12 revealed by 1.5/3T MR imaging. In patients with focal cortical dysplasia I, 7T MR imaging did not disclose morphologic abnormalities (<em>n</em> = 0/2). In patients with focal cortical dysplasia II, 7T uncovered morphologic signs that were not visible on clinical imaging in 1 patient with focal cortical dysplasia IIa (<em>n</em> = 1/4) and in all those with focal cortical dysplasia IIb (<em>n</em> = 6/6). T2*WI provided the highest added value, disclosing a peculiar intracortical hypointense band (black line) in 5/6 patients with focal cortical dysplasia IIb. The complete removal of the black line was associated with good postsurgical outcome (<em>n</em> = 4/5), while its incomplete removal yielded unsatisfactory results (<em>n</em> = 1/5).</p></div><div id="sec-4" class="subsection"><p id="p-6"><strong>CONCLUSIONS:</strong> The high sensitivity of 7T T2*-weighted images provides an additional tool in defining potential morphologic markers of high epileptogenicity within the dysplastic tissue of focal cortical dysplasia IIb and will likely help to more precisely plan epilepsy surgery and explain surgical failures.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">EEG<span class="def-item-dt-sep"></span></dt><dd>electroencephalography<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">FCD<span class="def-item-dt-sep"></span></dt><dd>focal cortical dysplasia<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">SWAN<span class="def-item-dt-sep"></span></dt><dd>susceptibility-weighted angiography</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2019 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org" rel="license">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/40/12/2137.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Ultra-High-Field Targeted Imaging of Focal Cortical Dysplasia: The Intracortical Black Line Sign in Type IIb</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">E.</span> <span class="nlm-surname">Bartolini</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Cosottini</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Costagli</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Barba</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Tassi</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Spreafico</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Garbelli</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Biagi</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Buccoliero</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Giordano</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Guerrini</span></span></span></div>
  
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      <div class="highwire-cite-title">Ultra-High-Field Targeted Imaging of Focal Cortical Dysplasia: The Intracortical Black Line Sign in Type IIb</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">E.</span> <span class="nlm-surname">Bartolini</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Cosottini</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Costagli</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Barba</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Tassi</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Spreafico</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Garbelli</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Biagi</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Buccoliero</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Giordano</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Guerrini</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Dec 2019, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(12) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">2137-2142; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6298 </span></div>
  
  
  
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