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Feng Wang,1,&ast; Shu-Ting Hong,1,&ast; Ying Zhang,2 Zhen Xing,3 Yuan-Xiang Lin1 1Neurosurgery Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 2Nuclear Medicine Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China; 3Radiology Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yuan-Xiang Lin, Neurosurgery Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China, Tel +8613906918894, Fax +86-591-83569369, Email lyx99070@163.comPurpose: To determine the diagnostic and localization value of 18F-fluorodeoxyglucose-positron emission tomography (PET)/computed tomography (CT) in patients with focal cortical dysplasia (FCD) who underwent epilepsy surgery.Methods: One hundred and eight patients with pathologically proven FCD who underwent surgery for refractory epilepsy were retrospectively analyzed. All patients underwent magnetic resonance imaging (MRI), 18F-FDG-PET/CT, and video electroencephalography. An MRI diagnosis of FCD was defined as MRI+. A PET/CT diagnosis of FCD was defined as PET/CT+.Results: MRI and PET/CT detected FCD in 20.37% and 93.52% of patients, respectively. The difference was significant. Twenty-one patients were MRI+/PET+, 80 were MRI-/PET+, six were MRI-/PET-, and one was MRI+/PET-. The MRI positivity rate was lowest in patients with FCD type IIIa (5.6%, P < 0.05). Prevalence of MRI-/PET+ was highest in patients with FCD type IIIa (88.89%, P < 0.05).Conclusion: PET/CT is superior to MRI in detecting FCD. FCD type IIIa was more likely than other types to show MRI-/PET+. This suggests that PET/CT has particular diagnostic value for FCD type IIIa patients with negative MRI findings.Keywords: focal cortical dysplasia

This study aimed to investigate the association between serum iron (SI) and postoperative delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH). We retrospectively analyzed 985 consecutive adult patients diagnosed with aSAH. Demographic, clinical, and laboratory data were recorded. Univariate and multivariate analyses were employed to assess the association between SI and DCI. Propensity-score matching (PSM) analysis was implemented to reduce confounding. Postoperative DCI developed in 14.38% of patients. Lower SI upon admission was detected in aSAH patients with severe clinical conditions and severe aSAH. SI was negatively correlated with WFNS grade (r = -0.3744, p < 0.001) and modified Fisher (mFisher) grade (r = -0.2520, p < 0.001). Multivariable analysis revealed lower SI was independently associated with DCI [odds ratios (OR) 0.281, 95% confidence interval (CI) 0.177-0.448, p < 0.001], while WFNS grade and mFisher grade were not. The receiver-operating characteristics (ROC) curve analysis of SI for DCI gave an area under the curve (AUC) of 0.7 and an optimal cut-off of 7.5 mu mol/L (95% CI 0.665 to 0.733, p < 0.0001). PSM demonstrated the DCI group had a significantly lower SI than the non-DCI group (10.91 +/- 6.86 vs. 20.34 +/- 8.01 mu mol/L, p < 0.001). Lower SI remained a significant independent predictor for DCI and an independent poor prognostic factor of aSAH in multivariate analysis (OR 0.363, 95% CI 0.209-0.630, p < 0.001). The predictive performance of SI for poor outcome had a corresponding AUC of 0.718 after PSM. Lower SI upon admission is significantly associated with WFNS grade, mFisher grade, and predicts postoperative DCI and poor outcome at 90 days following aSAH.