Examining the parents of children with tuberous sclerosis

Cerebral diffusion tensor imaging in tuberous sclerosis

PURPOSE

The purpose of this study was to investigate the features of the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in cortical tubers and white-matter lesions in patients with tuberous sclerosis (TS) using diffusion tensor imaging (DTI).

MATERIALS AND METHODS

Conventional magnetic resonance imaging (MRI) and DTI were performed in 14 patients with clinically established TS. Based on these DT images, ADC and FA maps were generated. The ADC values in 32 cortical tubers, and the ADC and FA values in 18 white-matter lesions were measured and compared with those of the corresponding contralateral regions.

RESULTS

Compared with the corresponding contralateral regions, cortical tubers of TS patients had significantly higher ADC values (P<0.001); white-matter lesions had significantly higher ADC values (P<0.001) and significantly lower FA values (P<0.001).

CONCLUSION

DTI is a useful tool for demonstrating changes in cortical tubers and white-matter lesions resulting from TS.

Increased Brain Apparent Diffusion Coefficient in Tuberous Sclerosis

PURPOSE

To evaluate the water diffusivity of normal-appearing white matter (NAWM) in patients with tuberous sclerosis complex compared with that in control subjects.

MATERIALS AND METHODS

Diffusion and conventional magnetic resonance (MR) imaging examinations were performed in 18 patients with clinically established tuberous sclerosis complex (10 male and eight female patients; mean age, 20.1 years; range, 12-30 years), as well as in 18 age-matched control subjects (nine male and nine female; mean age, 20.2 years; range, 11-28 years). Apparent diffusion coefficients (ADCs) were generated, and small elliptic regions of interest were manually placed both in perilesional NAWM and in six anatomic locations of NAWM remote from hamartomatous lesions. Perilesional ADCs were compared with those at the same anatomic site on the contralateral side of the brain (generalized linear regression analysis). ADCs from the predetermined sites in patients were compared with those in control subjects (generalized linear regression analysis).

RESULTS

Supratentorial ADCs were higher in patients with tuberous sclerosis complex than in control subjects, and statistically significant differences were observed in the occipital white matter, frontal white matter, centrum semiovale, parietal white matter, and corona radiata (for each location, P <.001). Significant increases were also seen in the perilesional NAWM compared with NAWM at the same anatomic locations on the contralateral side (P <.001). Infratentorial ADCs were normal.

CONCLUSION

Significant ADC increases were measured in the supratentorial NAWM.