Article Figures & Data
Figures
- FIG 1.
Study flow chart. NCNP indicates National Center of Neurology and Psychiatry.
- FIG 2.
Patient 19. A 26-month-old boy. Axial T2WI (A), FLAIR (B), T1WI (C), T1WI-MTC (D), and T1WI-CHESS (E). T2WI and FLAIR images demonstrate swelling of the cortex and subcortical hyperintensity, plus a linear hyperintensity extending to the ventricle, representing cortical tubers and RMLs, respectively (A and B, arrowheads and arrows, respectively). On T1WI, several RMLs can be seen as hyperintensity (C, arrows). The RMLs are more apparent on T1WI-MTC and especially on T1WI-CHESS (D and E, arrows).
- FIG 3.
Patient 4. A 29-year-old woman. Axial T2WI (A), FLAIR (B), T1WI (C), T1WI-MTC (D), and T1WI-CHESS (E). T2WI and FLAIR images demonstrate swollen cortices, some of which are accompanied by subcortical hyperintensities, representing cortical tubers (A and B, arrowheads). Linear hyperintensities in the subcortical area extending to the ventricle are observed, representing the RMLs (A and B, arrows). On T1WI, an RML is found in the right parietal lobe (C, arrow). T1WI-TMC and T1WI-CHESS are able to detect more RMLs than T1WI, T2WI, and FLAIR (D and E, arrows). The RMLs are more apparent on T1WI-CHESS than on T1WI-MTC (D and E, arrows). Although no obvious cortical tuber is shown by T1WI, both T1WI-MTC and T1WI-CHESS detect a cortical tuber as a slight hyperintensity (D and E, arrowheads).
- FIG 4.
Comparison of the CRtuber among T1WI, T1WI-MTC, and T1WI-CHESS.
- FIG 5.
Comparison of the CRRML among T1WI, T1WI-MTC, and T1WI-CHESS.
- FIG 6.
MR imaging findings of the surgical case, a 20-month-old boy with repeat epileptic seizures. A, Axial T2WI shows swelling of the cortex and subcortical hyperintensity (arrows), consistent with a cortical tuber. No other lesions are noted on T1WI, T2WI, and FLAIR (not shown); suggesting focal cortical dysplasia or a solitary cortical tuber. B, Axial T1WI-CHESS shows marked hyperintensity in the swollen cortex and subcortical white matter (arrows). C–E, Axial T1WI-CHESS shows several RMLs as linear hyperintense areas (arrows). On the basis of these findings, the patient was diagnosed with TSC.
- FIG 7.
Pathologic findings of the surgical case, a 20-month-old boy with repeat epileptic seizures. A, Many balloon cells are seen in the thickened cortex (arrowheads as examples). B, In subcortical WM, many balloon cells (arrowheads as examples) are seen in the left part of the white rectangle. Rare balloon cells (arrow) are present in the right part of the rectangle (star). C and D, Many balloon cells are observed in the subcortical white matter (arrowheads) and are immunoreactive for a monoclonal antibody against vimentin (1:400, M7020; Dako). A–C, Monoclonal antivimentin antibody. D, Hematoxylin-eosin staining. Scale bars: A and B, 500 μm. C, 100 μm. D, 10 μm.
Tables
T2WI FLAIR T1WI T1WI-MTC T1WI-CHESS Cortical tuber 17.1 (SD, 10.8) 17.5 (SD, 10.8) 1.1 (SD, 2.3) 10.2 (SD, 6.7) 12.2 (SD, 7.7) RML 3.56 (SD, 2.3) 10.5 (SD, 8.1) 1.4 (SD, 3.9) 20.4 (SD, 12.1) 24.8 (SD, 15.4) Subependymal nodule 6.2 (SD, 4.3) 4.5 (SD, 3.0) 5.1 (SD, 3.2) 6.4 (SD, 3.7) 7.2 (SD, 3.9) ↵a Data are mean (SD).
T2WI FLAIR T1WI T1WI-MTC T1WI-CHESS Cortical tuber 0.959 0.903 0.984 0.786 0.768 RML 0.648 0.866 0.887 0.883 0.799 Subependymal nodule 0.826 0.618 0.822 0.947 0.899 T1WI T1WI-MTC T1WI-CHESS CRtuber 0.788 0.863 0.797 CRRML 0.713 0.884 0.792
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