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Subcortical Band Heterotopia Shows Increased Perfusion on Arterial Spin Labeling Maps

Published online by Cambridge University Press:  12 August 2021

Vasileios G. Xydis
Affiliation:
Faculty of Medicine, University of Ioannina, Ioannina, Greece
Anastasia Giantsouli
Affiliation:
Faculty of Medicine, University of Ioannina, Ioannina, Greece
Effrosyni Styliara
Affiliation:
Faculty of Medicine, University of Ioannina, Ioannina, Greece
George A. Alexiou*
Affiliation:
Faculty of Medicine, University of Ioannina, Ioannina, Greece
Iliada Nakou
Affiliation:
Faculty of Medicine, University of Ioannina, Ioannina, Greece
Loukas G. Astrakas
Affiliation:
Faculty of Medicine, University of Ioannina, Ioannina, Greece
Maria I. Argyropoulou
Affiliation:
Faculty of Medicine, University of Ioannina, Ioannina, Greece
*
Correspondence to: George Alexiou, MD, Department of Neurosurgery, University of Ioannina, School of Medicine, Ioannina45500, Greece. Email: galexiou@uoi.gr, alexiougr@gmail.com
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Abstract

Type
Neuroimaging Highlight
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation

Subcortical band heterotopia (SBH) results from arrested migration of neurons in the subcortical or deep white matter (WM). Reference Severino, Geraldo and Utz1 It is characterized by the presence of a smooth band of poorly organized neurons, extending between the germinal matrix and the cortex. In the SBH, the parenchyma consists of four layers: deep WM, heterotopic gray matter, subcortical WM, and cortex. A high incidence of epilepsy has been reported in patients with SBH and detecting the epileptic focus might be useful in their management. An increased neuronal activity has been previously reported in SBH by showing increased glucose uptake in positron emission tomography (PET) and increased perfusion in Single Photon Emission Computed Tomography (SPECT). Reference Ito, Nakata and Matsuda2 We present a case of SBH showing on arterial spin labeling (ASL) increased relative cerebral blood flow of the heterotopic band, like that of the cortex. ASL, which assesses brain perfusion without intravenous injection of any contrast material, might be useful in the evaluation of neuronal activity of an SBH and thus in the detection of the epileptogenic area (Figure 1).

Figure 1: T2-weighted and perfusion image of a subcortical band heterotopia case. Axial T2 (left) (TR 2945ms, TE 80 ms, 364 × 280 matrix, 4-mm slice thickness, Gap 1 mm, FOV 200 × 189) shows a four-layer appearance of the parenchyma (white matter-red arrows, gray matter-asterisks), Axial color arterial spin labeling (ASL) (TR 3955 ms, TE 23 ms, 64 × 65 matrix, 6-mm slice thickness, Gap 0 mm, FOV 160 × 169) relative cerebral blood flow (rCBF) map (right) shows a four-layer appearance with high rCBF (red color) in the cortex and the heterotopic band (asterisks) and lower rCBF (green color) in the white matter (arrows). Image registration was performed using the Statistical Parametric Mapping.

Conflict of Interest

None.

Statement of Authorship

Writing original draft: VGX, GAA, AG, FS.

Conceptualization, data curation: MIA, LGA, VGX,IN.

Data Analysis and interpretation: MIA, LGA, FS, AG, VGX.

Final approval: MIA, LGA, VGX, IN.

References

Severino, M, Geraldo, AF, Utz, N, et al. Definitions and classification of malformations of cortical development: practical guidelines. Brain. 2020;143:2874–94.CrossRefGoogle ScholarPubMed
Ito, K, Nakata, Y, Matsuda, H, et al. Evaluation of FDG-PET and ECD-SPECT in patients with subcortical band heterotopia. Brain Dev. 2014;36:578–84.CrossRefGoogle ScholarPubMed
Figure 0

Figure 1: T2-weighted and perfusion image of a subcortical band heterotopia case. Axial T2 (left) (TR 2945ms, TE 80 ms, 364 × 280 matrix, 4-mm slice thickness, Gap 1 mm, FOV 200 × 189) shows a four-layer appearance of the parenchyma (white matter-red arrows, gray matter-asterisks), Axial color arterial spin labeling (ASL) (TR 3955 ms, TE 23 ms, 64 × 65 matrix, 6-mm slice thickness, Gap 0 mm, FOV 160 × 169) relative cerebral blood flow (rCBF) map (right) shows a four-layer appearance with high rCBF (red color) in the cortex and the heterotopic band (asterisks) and lower rCBF (green color) in the white matter (arrows). Image registration was performed using the Statistical Parametric Mapping.