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AJNR - American Journal of Neuroradiology

Published ahead of print on January 15, 2009
doi: 10.3174/ajnr.A1428

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Pulsed Arterial Spin-Labeled MR Imaging Evaluation of Tuberous Sclerosis

J.M. Pollock^c, C.T. Whitlow^a, H. Tan^b, R.A. Kraft^b, J.H. Burdette^a and J.A. Maldjian^a

^a Department of Radiology, Wake Forest University, Winston-Salem, NC
^b Department of Biomedical Engineering, Wake Forest University, Winston-Salem, NC
^c Department of Radiology, Oregon Health and Science University, Portland, Ore

View larger version (32K): [in this window] [in a new window]   Fig 1. Summary of hamartoma perfusion data for each patient. The average of the hyperperfused lesions is shown in green. The average of the hypoperfused lesions is shown in blue. The mean unaffected gray matter perfusion is shown in red.

View larger version (46K): [in this window] [in a new window]   Fig 2. Hypoperfused cortical tuber. Axial T2 (left), axial T1 (center), and quantitative CBF map from the PASL sequence show a cortical tuber (arrowheads) with high T2 signal intensity, mixed T1 signal intensity, and significant hypoperfusion on PASL.

View larger version (55K): [in this window] [in a new window]   Fig 3. Hyperperfused and hypoperfused cortical tubers. Axial T2-weighted image shows multiple cortical tubers in the right parietal lobe. Additional smaller tubers are seen in the left frontal cortex. Quantitative CBF map from the PASL sequence demonstrates alternating bands of hypoperfusion (arrowhead) and hyperperfusion (arrow) corresponding to the tubers. Additional areas of hyperperfusion are seen in the cortex, but these tubers did not meet size criteria to be included in the study.

View larger version (43K): [in this window] [in a new window]   Fig 4. Subependymal giant cell astrocytomas on T1 postcontrast and PASL. Mean perfusion of the lesions was 93.5 mL/100 g/min. Despite some calcifications in the tumors, the PASL sequence still showed that the lesions (arrow and arrowhead) were significantly hyperperfused relative to mean gray matter. A third lesion is partially seen on the contrasted image at the left foramen of Monroe.