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Findings in Susceptibility Weighted Imaging in Pediatric Patients with Migraine with Aura
European Journal of Paediatric Neurology ( IF 2.3 ) Pub Date : 2020-09-01 , DOI: 10.1016/j.ejpn.2020.05.008
Frauke Kellner-Weldon 1 , Vera Franziska Lehmann 1 , Philipe Sebastian Breiding 2 , Lorenz Grunder 2 , Raphaela Muri 1 , Manuela Pastore-Wapp 1 , Sandra Bigi 3 , Roland Wiest 2 , Marwan El-Koussy 2 , Nedelina Slavova 2
Affiliation  

BACKGROUND Migraine with aura (MwA) in pediatric patients is clinically frequent. Clinically complex symptoms need to be differentiated to exclude mimicking conditions. PURPOSE We hypothesize that MwA in children induces abnormalities readily visible in perfusion time to peak (TTP) maps as well as non-enhanced susceptibility weighted magnetic resonance imaging (SWI). MATERIALS AND METHODS Between 2010 and 2018, we retrospectively evaluated symptoms and imaging of consecutive pediatric patients <18 years with MwA. We visually scored abnormalities on SWI and TTP maps in 12 regions of interest on both hemispheres on three axial slices, as normal, slightly, distinctly or severely abnormal. RESULTS 99 patients (69.7% female), mean age 14.07 y (±2.8) were included. Focally increased deoxygenation (FID) in SWI was present in 61.6%. FID on SWI was dominant for the left hemisphere (60.7% vs. 31.1%, (p < .001)), and in 8.2% symmetric. Side of aura symptoms and contralateral hemispheric imaging alterations in patients with FID correlated significantly (p = .002.). 61 of 99 patients had perfusion MR and 59% of these patients showed focal increase of TTP. Age correlated significantly with FID in SWI (r = -.248, p = .013) and increase of TTP in perfusion (r = -.252, p = .05). Focal abnormalities correlated significantly between SWI and TTP maps. Brain regions most often abnormal were the temporal superior, occipital and fronto-parietal regions. CONCLUSIONS This study provides confidence in recognizing FID, and linking FID in SWI to acute MwA in pediatric patients. FID phenomenon had a left hemispheric significant dominance, and can be found bilaterally.

中文翻译:

小儿先兆偏头痛患者的磁敏感加权成像结果

背景 儿科患者的先兆偏头痛 (MwA) 在临床上很常见。需要区分临床复杂的症状以排除模仿条件。目的我们假设儿童的 MwA 会导致在灌注峰值时间 (TTP) 图中以及非增强磁敏加权磁共振成像 (SWI) 中容易看到的异常。材料和方法 2010 年至 2018 年期间,我们回顾性评估了连续 18 岁以下 MwA 儿科患者的症状和影像学。我们在三个轴向切片上对两个半球的 12 个感兴趣区域的 SWI 和 TTP 地图上的异常进行了视觉评分,如正常、轻微、明显或严重异常。结果 包括 99 名患者(69.7% 女性),平均年龄 14.07 岁 (±2.8)。SWI 中局部增加的脱氧 (FID) 占 61.6%。SWI 上的 FID 在左半球占主导地位(60.7% 对 31.1%,(p < .001)),对称性占 8.2%。FID 患者的先兆侧症状和对侧半球影像学改变显着相关 (p = .002.)。99 名患者中有 61 名有灌注 MR,其中 59% 的患者显示 TTP 局灶性增加。年龄与 SWI 中的 FID (r = -.248, p = .013) 和灌注中 TTP 的增加 (r = -.252, p = .05) 显着相关。SWI 和 TTP 地图之间的局灶性异常显着相关。最常异常的脑区是颞上区、枕区和额顶区。结论 本研究为识别 FID 以及将 SWI 中的 FID 与儿科患者的急性 MwA 联系起来提供了信心。FID 现象在左半球显着优势,并且可以在双侧发现。
更新日期:2020-09-01
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