Glutig Katja, Husain Ralf, Renz Diane, John-Kroegel Ulrike, Mentzel Hans-Joachim
Sektion Kinderradiologie, Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.
Tuberöse Sklerose-Zentrum Jena (TSD e. V.-zertifiziert), Zentrum für Seltene Erkrankungen (ZSE), Universitätsklinikum Jena, Jena, Deutschland.
Radiologie (Heidelb). 2022 Dec;62(12):1058-1066. doi: 10.1007/s00117-022-01053-z. Epub 2022 Aug 9.
Tuberous sclerosis complex (TSC) is a phakomatosis and is a tumor predisposition syndrome. As a genetic multisystem disease, patients present with a broad range of changes in the brain, heart, skin, kidneys, and lungs.
Which imaging modalities are required to monitor TSC patients according to current international recommendations?
Common findings in TSC are cortical tubers, subependymal nodules, and giant cell astrocytomas in the central nervous system (CNS), rhabdomyomas in the heart, and cysts and angiomyolipomas in the kidneys. Magnetic resonance imaging (MRI) of the brain and kidneys and abdominal ultrasound are the imaging modalities of choice, due to the very good soft tissue contrast and lack of X‑ray radiation.
Using standard and functional MRI sequences in a multimodal approach, the type, malignancy, size, and morphology of changes in TSC can be reliably determined. Abdominal ultrasound using high-resolution transducers can be used to rapidly and reliably detect even the smallest changes in the kidneys.
Regular follow-up of patients with TSC using MRI and ultrasound is necessary for early detection of complications, for planning individualized therapy, and for optimal lifelong care.
结节性硬化症(TSC)是一种 phakomatosis,是一种肿瘤易感性综合征。作为一种遗传性多系统疾病,患者在脑、心脏、皮肤、肾脏和肺部会出现广泛的变化。
根据当前国际建议,监测 TSC 患者需要哪些影像学检查方法?
TSC 的常见表现包括中枢神经系统(CNS)中的皮质结节、室管膜下结节和巨细胞星形细胞瘤,心脏中的横纹肌瘤,以及肾脏中的囊肿和血管平滑肌脂肪瘤。由于软组织对比度极佳且无 X 射线辐射,脑部和肾脏的磁共振成像(MRI)以及腹部超声是首选的影像学检查方法。
采用多模态方法使用标准和功能 MRI 序列,可以可靠地确定 TSC 病变的类型、恶性程度、大小和形态。使用高分辨率换能器的腹部超声可用于快速、可靠地检测肾脏中即使是最小的变化。
对 TSC 患者定期进行 MRI 和超声随访对于早期发现并发症、规划个体化治疗以及提供最佳的终身护理是必要的。