Intraoperative ultrasound in malformations of cortical development

Ultraschall Med. 2011 Dec;32 Suppl 2:E69-74. doi: 10.1055/s-0031-1273490. Epub 2011 Jul 20.


Purpose: Malformations of cortical development (MCD) are a common cause of medically refractory focal epilepsy. However, the intraoperative definition of MCD can be challenging. In this study we assess the feasibility of intraoperative ultrasound (IOUS) for the intraoperative localization of MCD.

Materials and methods: Five epilepsy patients with at least one suspected lesion of MCD were operated with the aid of IOUS. IOUS was compared to preoperative MRI and histopathology.

Results: In three cases of focal cortical dysplasia (FCD) type IIB and one case of periventricular heterotopia, the lesions could be delineated well on IOUS and the configuration of the lesion corresponded to the appearance on MRI. However, only one of two FCD type I lesions could be detected on IOUS.

Conclusion: IOUS can be helpful in defining FCD IIB as well as periventricular heterotopia intraoperatively, but this seems to be more difficult in FCD type I.

MeSH terms

  • Adolescent
  • Adult
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / pathology
  • Diffusion Magnetic Resonance Imaging
  • Dominance, Cerebral / physiology
  • Electroencephalography
  • Epilepsies, Partial / diagnostic imaging
  • Epilepsies, Partial / pathology
  • Epilepsies, Partial / surgery
  • Female
  • Frontal Lobe / abnormalities
  • Frontal Lobe / diagnostic imaging
  • Frontal Lobe / surgery
  • Humans
  • Image Interpretation, Computer-Assisted / instrumentation
  • Imaging, Three-Dimensional
  • Intraoperative Complications / diagnostic imaging*
  • Intraoperative Complications / pathology
  • Intraoperative Complications / surgery
  • Magnetic Resonance Imaging
  • Male
  • Malformations of Cortical Development / diagnostic imaging*
  • Malformations of Cortical Development / pathology
  • Malformations of Cortical Development / surgery*
  • Neuronavigation / instrumentation
  • Neuronavigation / methods
  • Preoperative Care
  • Prognosis
  • Temporal Lobe / abnormalities
  • Temporal Lobe / diagnostic imaging
  • Temporal Lobe / surgery
  • Transducers
  • Ultrasonography, Interventional / instrumentation
  • Ultrasonography, Interventional / methods*
  • Video Recording
  • Young Adult