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Pediatr Radiol. 2006 Feb;36(2):119-25. Epub 2005 Nov 11.

Comparative analysis of MR sequences to detect structural brain lesions in tuberous sclerosis.

Author information

1
Section of Radiology, Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.

Abstract

BACKGROUND:

Tuberous sclerosis (TS) is a neurocutaneous genetically inherited disease with variable penetrance characterized by dysplasias and hamartomas affecting multiple organs. MR is the imaging method of choice to demonstrate structural brain lesions in TS.

OBJECTIVE:

To compare MR sequences and determine which is most useful for the demonstration of each type of brain lesion in TS patients.

MATERIALS AND METHODS:

We reviewed MR scans of 18 TS patients for the presence of cortical tubers, white matter lesions (radial bands), subependymal nodules, and subependymal giant cell astrocytoma (SGCA) on the following sequences: (1) T1-weighted spin-echo (T1 SE) images before and after gadolinium (Gd) injection; (2) nonenhanced T1 SE sequence with an additional magnetization transfer contrast medium pulse on resonance (T1 SE/MTC); and (3) fluid-attenuated inversion recovery (FLAIR) sequence.

RESULTS:

Cortical tubers were found in significantly (P<0.05) larger numbers and more conspicuously in FLAIR and T1 SE/MTC sequences. The T1 SE/MTC sequence was far superior to other methods in detecting white matter lesions (P<0.01). There was no significant difference between the T1 SE/MTC and T1 SE (before and after Gd injection) sequences in the detection of subependymal nodules; FLAIR sequence showed less sensitivity than the others in identifying the nodules. T1 SE sequences after Gd injection demonstrated better the limits of the SGCA.

CONCLUSION:

We demonstrated the importance of appropriate MRI sequences for diagnosis of the most frequent brain lesions in TS. Our study reinforces the fact that each sequence has a particular application according to the type of TS lesion. Gd injection might be useful in detecting SGCA; however, the parameters of size and location are also important for a presumptive diagnosis of these tumors.

PMID:
16283285
DOI:
10.1007/s00247-005-0033-x
[Indexed for MEDLINE]

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