Wippold F J, Baber W W, Gado M, Tobben P J, Bartnicke B J
Section of Neuroradiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO.
J Comput Assist Tomogr. 1992 Jan-Feb;16(1):69-72. doi: 10.1097/00004728-199201000-00012.
The MR findings in eight patients with intracranial manifestations of tuberous sclerosis are reported. There were subependymal lesions in seven patients and peripheral lesions (i.e., cortical and subcortical) in all patients. All lesions were supratentorial. We emphasize two findings that have not been previously stressed. The signal intensity patterns of the subependymal lesions varied from patient to patient, but in all patients receiving intravenous contrast medium, the majority of these lesions enhanced. Although this finding may signify early breakdown of the blood-brain barrier with potential for lesion growth, the high frequency of enhancement challenges earlier concepts of equating this phenomenon with existence of actively growing giant cell astrocytomas. The peripheral lesions were more numerous than subependymal lesions. These lesions were nearly always hyperintense in the proton density weighted and T2-weighted images. Most notable is the fact that, in half of the lesions, signal intensity was also elevated in the T1-weighted image, an observation that has not been emphasized in previous reports. Although not pathologically confirmed this signal pattern may represent early stages of calcification within these lesions. Finally, unlike subependymal lesions, none of the peripheral lesions showed contrast enhancement.
报告了8例结节性硬化症颅内表现患者的磁共振成像（MR）结果。7例患者有室管膜下病变，所有患者均有外周病变（即皮质和皮质下病变）。所有病变均位于幕上。我们强调两个以前未被着重指出的发现。室管膜下病变的信号强度模式因人而异，但在所有接受静脉注射造影剂的患者中，这些病变大多有强化。尽管这一发现可能意味着血脑屏障早期破坏以及病变有生长的可能，但强化的高频率对早期将这种现象等同于活跃生长的巨细胞星形细胞瘤存在的概念提出了挑战。外周病变比室管膜下病变更多。这些病变在质子密度加权像和T2加权像上几乎总是高信号。最值得注意的是，在一半的病变中，T1加权像上信号强度也升高，这一观察结果在以前的报告中未被强调。尽管未经病理证实，但这种信号模式可能代表这些病变内钙化的早期阶段。最后，与室管膜下病变不同，外周病变均未显示造影剂强化。
