TY  - JOUR
A1  - Nöth, Ulrike
A1  - Gracien, René-Maxime
A1  - Maiworm, Michelle
A1  - Reif, Philipp Sebastian
A1  - Hattingen, Elke
A1  - Knake, Susanne
A1  - Wagner, Marlies
A1  - Deichmann, Ralf
T1  - Detection of cortical malformations using enhanced synthetic contrast images derived from quantitative T1 maps
T2  - NMR in biomedicine
N2  - The detection of cortical malformations in conventional MR images can be challenging. Prominent examples are focal cortical dysplasias (FCD), the most common cause of drug‐resistant focal epilepsy. The two main MRI hallmarks of cortical malformations are increased cortical thickness and blurring of the gray (GM) and white matter (WM) junction. The purpose of this study was to derive synthetic anatomies from quantitative T1 maps for the improved display of the above imaging characteristics in individual patients.
On the basis of a T1 map, a mask comprising pixels with T1 values characteristic for GM is created from which the local cortical extent (CE) is determined. The local smoothness (SM) of the GM‐WM junctions is derived from the T1 gradient. For display of cortical malformations, the resulting CE and SM maps serve to enhance local intensities in synthetic double inversion recovery (DIR) images calculated from the T1 map.
The resulting CE‐ and/or SM‐enhanced DIR images appear hyperintense at the site of cortical malformations, thus facilitating FCD detection in epilepsy patients. However, false positives may arise in areas with naturally elevated CE and/or SM, such as large GM structures and perivascular spaces.
In summary, the proposed method facilitates the detection of cortical abnormalities such as cortical thickening and blurring of the GM‐WM junction which are typical FCD markers. Still, subject motion artifacts, perivascular spaces, and large normal GM structures may also yield signal hyperintensity in the enhanced synthetic DIR images, requiring careful comparison with clinical MR images by an experienced neuroradiologist to exclude false positives.
KW  - cortical malformation
KW  - cortical thickness
KW  - double inversion recovery (DIR)
KW  - focal cortical dysplasia (FCD)
KW  - gray‐white matter blurring
KW  - quantitative T1 mapping
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/56310
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-563104
SN  - 1099-1492
VL  - 33
IS  - 2, e4203
PB  - Wiley
CY  - New York, NY
ER  -