Prognostic analysis in children with focal cortical dysplasia II undergoing epilepsy surgery: Clinical and radiological factors

作者：Siqi Zhang, Yi Luo, Yilin Zhao, Fengjun Zhu, Xianping Jiang, Xiaoyu Wang, Tong Mo, Hongwu Zeng · 发表于：Frontiers in Neurology · 年份：2023 · DOI：10.3389/fneur.2023.1123429 · 被引用次数：5 · 研究领域：Epilepsy research and treatment、Glioma Diagnosis and Treatment、Fetal and Pediatric Neurological Disorders

Objective The aim of this study was to investigate the value of clinical profiles and radiological findings in assessing postsurgical outcomes in children with focal cortical dysplasia (FCD) II while exploring prognostic predictors of this disease. Methods We retrospectively reviewed 50 patients with postoperative pathologically confirmed FCD II from January 2016 to June 2021. The clinical profiles and preoperative radiological findings were measured and analyzed. The patients were classified into four classes based on the Engel Class Outcome System at the last follow-up. For the analysis, the patients were divided into two categories based on Engel I and Engel II–IV, namely, seizure-free and non-seizure-free groups. Qualitative and quantitative factors were subsequently compared by groups using comparative statistics. Receiver operating characteristic (ROC) curves were used to identify the predictors of prognosis in children with FCD II. Results Thirty-seven patients (74%) had Engel class I outcomes. The minimum postsurgical follow-up was 1 year. At the epilepsy onset, patients who attained seizure freedom were older and less likely to have no apparent lesions on the preoperative MRI (“MRI-negative”). The non-seizure-free group exhibited a higher gray matter signal intensity ratio (GR) on 3D T1-MPRAGE images ( p = 0.006), with a lower GR on T2WI images ( p = 0.003) and FLAIR images ( p = 0.032). The ROC curve indicated that the model that combined the GR value of all MRI seq...