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

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

Author Gama, HPP Google Scholar
Rocha, A. J. da Google Scholar
Braga, F. T. Google Scholar
Silva, C. J. da Google Scholar
Maia, ACM Google Scholar
Meirelles, RGD Google Scholar
Rego, JIM do Google Scholar
Lederman, H. M. Google Scholar
Institution Santa Casa Misericordia São Paulo
Universidade Federal de São Paulo (UNIFESP)
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.
Keywords tuberous sclerosis
MRI
brain
Language English
Date 2006-02-01
Published in Pediatric Radiology. New York: Springer, v. 36, n. 2, p. 119-125, 2006.
ISSN 0301-0449 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 119-125
Origin http://dx.doi.org/10.1007/s00247-005-0033-x
Access rights Closed access
Type Article
Web of Science ID WOS:000234570400005
URI http://repositorio.unifesp.br/handle/11600/28718

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