The Value Of Rapid Pathological Diagnosis Of Label-Free Multiphoton Microscopy In Intracranial Lesions With Epilepsy With Hyperintensity T2 In MRI

Objective:Label-free multiphoton microscopy was used to identify lesions with epilepsy as the first symptom,which showed a hyperintensity T2 magnetic resonance signal change,and compared with traditional pathological staining images to evaluate its value in the diagnosis of the above lesions.Methods:A total of 29 patients with epilepsy who underwent concurrent surgical treatment of Department of neurosurgery at the The First Affiliated Hospital of Fujian Medical University from 2011 to 2017 were enrolled.MRI revealed 29 patients with intracranial lesions with hyperintensity T2.Surgical resected fresh brain tissue specimens were embedded to form a frozen mass,and the region of interest was cut into 6 consecutive 10 ?m thick coronal slices.In order to compare the histology of different methods,the middle two of the above six serial sections were subjected to standard HE staining and conventional NeuN immunohistochemistry,and the remaining sections were subjected to label-free multiphoton microscopy to compare the differences between different imaging methods.Results:There were 18 males and 11 females;the age ranged from 4 to 51 years,with an average of 22.1±12.2 years;the duration of seizures ranged from 3 days to 17 years,with a median of 24 months;8 cases with preoperative seizure frequency ?1 times/week,21 patients with <1 time/week;patients with simple epilepsy surgery(17 patients)underwent epilepsy with intracortical electroencephalography(ECoG)monitoring,and patients with epilepsy and tumors(12 patients)underwent surgery according to tumor surgery the lesions were completely resected and the epilepsy lesions were treated under ECoG monitoring;the patients were followed up for 1 to 5 years.All surgical specimens were subjected to routine HE staining and necessary immunohistochemical examination:(1)surgical resection site: divided by brain lobe: 14 cases of temporal lobe,4 cases of frontal lobe,4 cases of parietal lobe,3 cases of occipital lobe,multi-brain There were 4 cases of leaf resection;11 cases of left cerebral hemisphere lesions and 18 cases of right cerebral hemisphere lesions.(2)Postoperative pathological types: 7 cases of Focal Cortical Dysplasia(FCD)and 22 cases of neoplastic lesions.(3)Tumor type description: 13 cases of embryonic dysplastic neuroepithelial tumor(DNT)and 9 cases of ganglioglioma(GG).In contrast to postoperative pathology,preoperative MRI failed to provide a diagnosis(only positionable)of 17 patients,and 12 patients who were able to provide a propensity diagnosis(preliminary qualitative diagnosis).Conclusion:For epilepsy as the first symptom,preoperative MRI is a lesion with hyperintensity T2.Label-free multiphoton microscopy can identify neurons and glial cells,recognize the cellular components and tissue structure of the cortex,and realize real-time imaging.Minimally invasive,rapid and accurate inspection technology is conducive to the identification of FCD and low-grade tumors during surgery,combined with electrophysiological monitoring,to achieve the goal of completely cutting tumors and epileptic foci and improving prognosis.