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.

中文翻译：

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使用源自定量T1图的增强的合成对比图像检测皮质畸形。

传统MR图像中的皮质畸形的检测可能是具有挑战性的。突出的例子是局灶性皮质发育异常（FCD），这是耐药性局灶性癫痫的最常见原因。皮质畸形的两个主要MRI标志是皮质厚度增加以及灰色（GM）和白质（WM）连接处模糊。这项研究的目的是从定量的T1图中得出合成的解剖结构，以改善上述影像学特征在单个患者中的显示。基于T1图，创建包括具有针对GM的T1值特征的像素的掩模，由此确定局部皮层范围（CE）。GM-WM结的局部平滑度（SM）是从T1梯度得出的。为了显示皮质畸形，生成的CE和SM图可增强从T1图计算出的合成双反演恢复（DIR）图像中的局部强度。所得的CE和/或SM增强的DIR图像在皮质畸形部位表现出高强度，从而有助于癫痫患者的FCD检测。但是，CE和/或SM自然升高的区域可能会出现假阳性，例如大的GM结构和血管周间隙。总之，所提出的方法有助于检测皮质异常，例如皮质增厚和GM-WM连接的模糊，这是典型的FCD标记。尽管如此，受检者的运动伪影，血管周围间隙和大型正常GM结构也可能会在增强的合成DIR图像中产生信号超信号，