Epilepsy is a common neurological disorder with focal cortical dysplasia (FCD) being one of the most common lesional causes. Detection of FCD by MRI is a major determinant of surgical outcome. Evolution of MRI sequences and hardware has greatly increased the detection rate of FCD, but these gains have largely been related to the more visible Type IIb FCD, with Type I and IIa remaining elusive. While most sequence improvements have relied on increasing contrast between gray and white matter, we propose a novel imaging approach, 3D Edge-Enhancing Gradient Echo (3D-EDGE), to directly image the gray-white boundary. By acquiring images at an inversion time where gray and white matter have equal signal but opposite phases, voxels with a mixture of gray and white matter (e.g., at the gray-white boundary) will have cancellation of longitudinal magnetization producing a thin area of signal void at the normal boundary. By creating greater sensitivity for minor changes in T1 relaxation, microarchitectural abnormalities present in FCD produce greater contrast than on other common MRI sequences. 3D-EDGE had a significantly greater contrast ratio between lesion and white matter for FCD compared to MP2RAGE (98% vs 17%; p = 0.0006) and FLAIR (98% vs 19%; p = 0.0006), which highlights its potential to improve outcomes in epilepsy. We present a discussion of the framework for 3D-EDGE, optimization strategies, and analysis of a series of FCDs to highlight the benefit of 3D-EDGE in FCD detection compared to commonly used sequences in epilepsy.

癫痫病是一种常见的神经系统疾病，局灶性皮质发育异常（FCD）是最常见的病因之一。MRI对FCD的检测是决定手术结果的主要因素。MRI序列和硬件的发展极大地提高了FCD的检测率，但这些收益很大程度上与更明显的IIb型FCD有关，而I型和IIa型仍然难以捉摸。虽然大多数序列改进都依赖于增加灰质和白质之间的对比度，但我们提出了一种新颖的成像方法，即3D边缘增强梯度回波（3D-EDGE），可以直接成像灰白色边界。通过在灰白色物质具有相同信号但相位相反的反演时间获取图像，可以将灰白色物质混合的体素（例如，（在灰白色边界处）将消除纵向磁化强度，从而在正常边界处产生信号空隙的薄区域。通过为T1弛豫的细微变化创建更高的灵敏度，与其他常见的MRI序列相比，FCD中存在的微体系结构异常产生了更大的对比度。与MP2RAGE（98％vs 17％; p = 0.0006）和FLAIR（98％vs 19％; p = 0.0006）相比，FCD的3D-EDGE在病变和白质之间具有明显更高的对比度，这凸显了其改善的潜力癫痫的预后。我们提出了有关3D-EDGE框架，优化策略以及一系列FCD分析的讨论，以突出显示3D-EDGE与癫痫患者常用序列相比在FCD检测中的优势。通过为T1弛豫的细微变化创建更高的灵敏度，与其他常见的MRI序列相比，FCD中存在的微体系结构异常产生了更大的对比度。与MP2RAGE（98％vs 17％; p = 0.0006）和FLAIR（98％vs 19％; p = 0.0006）相比，FCD的3D-EDGE在病变和白质之间具有明显更高的对比度，这凸显了其改善的潜力癫痫的预后。我们提出了有关3D-EDGE框架，优化策略以及一系列FCD分析的讨论，以突出显示3D-EDGE与癫痫患者常用序列相比在FCD检测中的优势。通过为T1弛豫的细微变化创建更高的灵敏度，与其他常见的MRI序列相比，FCD中存在的微体系结构异常产生了更大的对比度。与MP2RAGE（98％vs 17％; p = 0.0006）和FLAIR（98％vs 19％; p = 0.0006）相比，FCD的3D-EDGE在病变和白质之间具有明显更高的对比度，这凸显了其改善的潜力癫痫的预后。我们提出了有关3D-EDGE框架，优化策略以及一系列FCD分析的讨论，以突出显示3D-EDGE与癫痫患者常用序列相比在FCD检测中的优势。与MP2RAGE（98％vs 17％; p = 0.0006）和FLAIR（98％vs 19％; p = 0.0006）相比，FCD的3D-EDGE在病变和白质之间具有明显更高的对比度，这凸显了其改善的潜力癫痫的预后。我们提出了有关3D-EDGE框架，优化策略以及一系列FCD分析的讨论，以突出显示3D-EDGE与癫痫患者常用序列相比在FCD检测中的优势。与MP2RAGE（98％vs 17％; p = 0.0006）和FLAIR（98％vs 19％; p = 0.0006）相比，FCD的3D-EDGE在病变和白质之间具有明显更高的对比度，这凸显了其改善的潜力癫痫的预后。我们提出了有关3D-EDGE框架，优化策略以及一系列FCD分析的讨论，以突出显示3D-EDGE与癫痫患者常用序列相比在FCD检测中的优势。