Mirrored structural symmetry index (VMSSI): a novel approach for diagnosing MR-negative focal cortical dysplasia using structural MRI.

Discussion The results of this study demonstrated three key findings that advance the diagnostic landscape of MRI-negative FCD: firstly, the cortical thickness symmetry index (MeanThicknessDiff) exhibits a highly significant difference between MRI-negative FCD patients and healthy controls ( p < 0.001); secondly, the composite Voxel-Mirrored Structural Symmetry Index (VMSSI) is substantially elevated in MRI-negative FCD patients compared to matched controls ( p < 0.001); and thirdly, VMSSI achieves a robust diagnostic performance with an area under the curve (AUC) of 0.80 (95% CI: 0.72–0.88), accompanied by 77% sensitivity and 85% specificity, outperforming single-feature analyses of either magnetic resonance signal intensity or cortical thickness symmetry.

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