MRI Head Coil Malfunction Producing Artifacts Mimicking Malformation of Cortical Development in Pediatric Epilepsy Work-Up

MR imaging of the brain of case 1 at presentation (A–D) and 20 days later (E–H). On the sagittal and axial T1WI (A and B) and the axial T2WI (C) of the first scan, the cerebral cortices of the bilateral frontal lobes show apparent irregular surfaces and gray-white matter junctions. Because the irregularity was observed on both T1WI and T2WI and the posterior cerebral cortices have rather smooth surfaces, without knowing the possibility of coil malfunction, we interpreted the findings as possible polymicrogyria. On the sagittal and axial T1WI (E and F) and the axial T2WI (G) of the follow-up scan obtained only 20 days later, the irregularity is no longer present, suggesting that the irregular appearance of the cortex seen on the first scan is artifactual rather than pathologic. When the window setting was adjusted to evaluate the background noise of the axial T1WI of the first (D) and follow-up (H) scan, it is obvious that the first scan has pronounced background noise in the frontal part of the image.