Purpose: There are brain anatomical variants and structural alterations, particularly within the anterior temporal lobe region, hippocampus and motor cortex that can be misinterpreted as potentially epileptogenic foci and may cause unnecessary diagnostic follow-up imaging or worse unnecessary treatment. The purpose of this exhibition is to describe normal variants and discuss their imaging findings.
Radiologist must be familiar with both the normal brain anatomy as well as numerus variants that mimic pathology in the context of epilepsy imaging. After reviewing this exhibit, the viewer will have a comprehensive understanding of numerus anatomical variants that can be mistakenly interpreted as tumors, heterotopia and cystic lesions.
Approach/Methods:
1. Review normal anterior temporal lobe and hippocampal anatomy in relationship with anatomical variants mimicking potentially epileptogenic lesions in patients with epilepsy.
2. Highlight imaging appearances of these CNS structural alterations findings.
3. Demonstrate how familiarity with normal anatomical variants and structural ndings. can play a critical role in accurate imaging diagnosis, MEG/PET interpretation, clinical decision making, and management.
Discussion: This educational exhibit will review these anatomic variations: choroidal fissure cyst, hippocampal sulcal remnants, malrotation of hippocampus, asymmetric gyri (e.g., split motor cortex), caudate tail mimicking heterotopia, nodularity of hippocampus, perivascular space in anterior temporal lobe mimicking a cystic tumor, DVA causing hypoperfusion on PET imaging mimicking seizure focus, among others.
Conclusion: Radiologists may be less familiar with normal anatomical variants and structural changes. After reviewing this exhibit, the viewer will have a comprehensive understanding of various don`t touch lesions and anatomical variations that may mimic a seizure focus in patients with epilepsy and thereby minimizing interpretive errors.
