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Fig 4. T1-weighted and SWI MR imaging fused with PET images of a 2.8 year-old girl (patient 4) with Sturge-Weber syndrome affecting the right hemisphere. T1-weighted images show focal posterior parietal atrophy with leptomeningeal gadolinium enhancement and subtle enhancement in the white matter, consistent with transmedullary veins. The same deep veins are well visualized on SWI (thick arrows), apparently connected to enlarged periventricular veins (thin arrows on the enlarged fused SWI/PET image). FDG-PET shows severe hypometabolism in the area of focal atrophy, while the transmedullary veins reach adjacent cortical regions with mild or no hypometabolism. The SWI/PET fusion image shows well the configuration of multiple draining veins (arrows) originating from the edge of the hypometabolic area.
