Skip to main content

Advertisement

Log in

Magnetic resonance imaging of anterior temporal lobe cysts in children: discriminating special imaging features in a particular group of diseases

  • Paediatric Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Introduction

We hypothesised that disorders with anterior temporal lobe (ATL) cysts might exhibit common peculiarities and distinguishable imaging features that could be useful for diagnosis. We reviewed a series of patients for neuroimaging contributions to specific diagnoses.

Methods

A literature search was conducted, and institutional imaging files were reviewed to identify MR examinations with ATL cysts in children. Patients were divided according to head size, calcifications, white matter and cortical abnormalities. Unsupervised hierarchical clustering of patients on the basis of their MR and CT items was performed.

Results

We identified 23 patients in our database in whom MR revealed ATL cysts. Our series included five patients with congenital muscular dystrophy (05/23 = 21.7 %), six with megalencephalic leukoencephalopathy with subcortical cysts (06/23 = 26.1 %), three with non-megalencephalic leukoencephalopathy with subcortical cysts (03/23 = 13.1 %), seven with congenital cytomegalovirus disease (07/23 = 30.4 %) and two with Aicardi–Goutières syndrome (02/23 = 8.7 %). After analysis, 11 clusters resulted in the highest discriminative indices. Thereafter, patients’ clusters were linked to their underlying diseases. The features that best discriminated between clusters included brainstem abnormalities, cerebral calcifications and some peculiar grey and white matter abnormalities. A flow chart was drafted to guide the radiologist in these diagnoses.

Conclusions

The authors encourage the combined interpretation of these features in the herein proposed approach that confidently predicted the final diagnosis in this particular group of disorders associated with ATL cysts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Osborn AG, Preece MT (2006) Intracranial cysts: radiologic-pathologic correlation and imaging approach. Radiology 239(3):650–664

    Article  PubMed  Google Scholar 

  2. Labrune P, Lacroix C, Goutieres F, de Laveaucoupet J, Chevalier P, Zerah M, Husson B, Landrieu P (1996) Extensive brain calcifications, leukodystrophy, and formation of parenchymal cysts: a new progressive disorder due to diffuse cerebral microangiopathy. Neurology 46(5):1297–1301

    Article  CAS  PubMed  Google Scholar 

  3. Naidu S, Bibat G, Lin D, Burger P, Barker P, Rosemberg S, Braverman N, Arroyo H, Dowling M, Hamosh A, Kimonis V, Blank C, Fiumara A, Facchini S, Singhal B, Moser H, Kelley R, DiMauro S (2005) Progressive cavitating leukoencephalopathy: a novel childhood disease. Annals Neurol 58(6):929–938. doi:10.1002/ana.20671

    Article  Google Scholar 

  4. Biancheri R, Rossi D, Cassandrini D, Rossi A, Bruno C, Santorelli FM (2010) Cavitating leukoencephalopathy in a child carrying the mitochondrial A8344G mutation. AJNR Am J Neuroradiol 31(9):E78–E79. doi:10.3174/ajnr.A2182

    Article  CAS  PubMed  Google Scholar 

  5. Sureka J, Jakkani R (2012) Clinico-radiological spectrum of bilateral temporal lobe hyperintensity: a retrospective review. British J Radiol 85(1017):e782–e792. doi:10.1259/bjr/30039090

    Article  CAS  Google Scholar 

  6. Rawal S, Croul SE, Willinsky RA, Tymianski M, Krings T (2013) Subcortical cystic lesions within the anterior superior temporal gyrus: a newly recognized characteristic location for dilated perivascular spaces. AJNR Am J Neuroradiol. doi:10.3174/ajnr.A3669

    PubMed  Google Scholar 

  7. Schiffmann R, van der Knaap MS (2009) Invited article: an MRI-based approach to the diagnosis of white matter disorders. Neurology 72(8):750–759. doi:10.1212/01.wnl.0000343049.00540.c8

    Article  PubMed Central  PubMed  Google Scholar 

  8. Fink KR, Thapa MM, Ishak GE, Pruthi S (2010) Neuroimaging of pediatric central nervous system cytomegalovirus infection. Radiographics Rev Publ Radiol Soc North Am Inc 30(7):1779–1796. doi:10.1148/rg.307105043

    Google Scholar 

  9. van der Knaap MS, Vermeulen G, Barkhof F, Hart AA, Loeber JG, Weel JF (2004) Pattern of white matter abnormalities at MR imaging: use of polymerase chain reaction testing of Guthrie cards to link pattern with congenital cytomegalovirus infection. Radiology 230(2):529–536

    Article  PubMed  Google Scholar 

  10. van der Knaap MS, Valk J, Barkhof F (2005) Magnetic resonance of myelination and myelin disorders, 3rd edn. Springer, Berlin ; New York

    Book  Google Scholar 

  11. Raybaud C, Barkovich AJ et al (2011) Pediatric neuroimaging. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  12. Tortori-Donati P, Rossi A, Biancheri R (2005) Pediatric neuroradiology. Springer, Berlin ; New York

    Book  Google Scholar 

  13. Roche AF, Mukherjee D, Guo SM, Moore WM (1987) Head circumference reference data: birth to 18 years. Pediatrics 79(5):706–712

    CAS  PubMed  Google Scholar 

  14. van der Knaap MS, Barth PG, Stroink H, van Nieuwenhuizen O, Arts WF, Hoogenraad F, Valk J (1995) Leukoencephalopathy with swelling and a discrepantly mild clinical course in eight children. Annals Neurol 37(3):324–334. doi:10.1002/ana.410370308

    Article  Google Scholar 

  15. Olivier M, Lenard HG, Aksu F, Gartner J (1998) A new leukoencephalopathy with bilateral anterior temporal lobe cysts. Neuropediatrics 29(5):225–228. doi:10.1055/s-2007-973566

    Article  CAS  PubMed  Google Scholar 

  16. Biancheri R, Pisaturo C, Perrone MV, Pessagno A, Rossi A, Veneselli E (2000) Presence of delayed myelination and macrocephaly in the sister of a patient with vacuolating leukoencephalopathy with subcortical cysts. Neuropediatrics 31(6):321–324. doi:10.1055/s-2000-12949

    Article  CAS  PubMed  Google Scholar 

  17. Gomes AL, Vieira JP, Saldanha J (2001) Non-progressive leukoencephalopathy with bilateral temporal cysts. Eur J Paediatr Neurol 5(3):121–125

    Article  CAS  PubMed  Google Scholar 

  18. Battini R, Bianchi MC, Tosetti M, Guzzetta A, Cioni G (2002) Leukoencephalopathy with bilateral anterior temporal lobe cysts: a further case of this new entity. J Child Neurol 17(10):773–776

    Article  PubMed  Google Scholar 

  19. Yalcinkaya C, Yuksel A, Comu S, Kilic G, Cokar O, Dervent A (2003) Epilepsy in vacuolating megalencephalic leukoencephalopathy with subcortical cysts. Seizure 12(6):388–396

    Article  PubMed  Google Scholar 

  20. Anlar B, Yalaz K, Saatci I (2003) Bilateral temporal cysts in a case of subacute sclerosing panencephalitis. Eur J Paediatr Neurol 7(2):81–84

    Article  PubMed  Google Scholar 

  21. Henneke M, Preuss N, Engelbrecht V, Aksu F, Bertini E, Bibat G, Brockmann K, Hubner C, Mayer M, Mejaski-Bosnjak V, Naidu S, Neumaier-Probst E, Rodriguez D, Weisz W, Kohlschutter A, Gartner J (2005) Cystic leukoencephalopathy without megalencephaly: a distinct disease entity in 15 children. Neurology 64(8):1411–1416

    Article  CAS  PubMed  Google Scholar 

  22. Grosso S, Cerase A, De Stefano N, Marco LD, Galluzzi P, Galimberti D, Morgese G, Balestri P (2005) Non-progressive leukoencephalopathy with bilateral anterior temporal cysts: a case report and review of the literature. Brain Dev 27(1):73–77

    Article  PubMed  Google Scholar 

  23. Bodensteiner JB, Kerrigan JF, Johnsen SD (2006) Leukoencephalopathy with bilateral anterior temporal lobe cysts. J Child Neurol 21(5):419–422

    PubMed  Google Scholar 

  24. O'Rourke D, Bradley L, King MD, Ryan S (2010) Leukoencephalopathy with anterior temporal cysts due to congenital CMV infection diagnosed retrospectively. J Neuroimaging 20(3):292–293

    Article  PubMed  Google Scholar 

  25. Hoffmann C, Grossman R, Bokov I, Lipitz S, Biegon A (2010) Effect of cytomegalovirus infection on temporal lobe development in utero: quantitative MRI studies. Eur Neuropsychopharmacol 20(12):848–854

    Article  CAS  PubMed  Google Scholar 

  26. Manara R, Balao L, Baracchini C, Drigo P, D'Elia R, Ruga EM (2011) Brain magnetic resonance findings in symptomatic congenital cytomegalovirus infection. Pediatr Radiol 41(8):962–970. doi:10.1007/s00247-011-2120-5

    Article  PubMed  Google Scholar 

  27. Kamate M, Bhandankar M, Dhaded SM, Hattiholi V (2011) MRI abnormalities of the anterior temporal lobe: a new indicator of congenital cytomegalovirus infection. Indian Pediatr 48(4):325–328

    PubMed  Google Scholar 

  28. Xie H, Wang J, Dhaunchak AS, Shang J, Kou L, Guo M, Wu Y, Gu Q, Colman D, Wu X, Jiang Y (2012) Functional studies of MLC1 mutations in Chinese patients with megalencephalic leukoencephalopathy with subcortical cysts. PLoS One 7((3):e33087. doi:10.1371/journal.pone.0033087

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  29. Sureka J, Jakkani RK (2012) Clinico-radiological spectrum of bilateral temporal lobe hyperintensity: a retrospective review. Br J Radiol 85(1017):e782–e792

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  30. Renaud DL (2012) Leukoencephalopathies associated with macrocephaly. Semin Neurol 32(1):34–41. doi:10.1055/s-0032-1306384

    Article  PubMed  Google Scholar 

  31. Koyama S, Kawanami T, Arawaka S, Wada M, Kato T (2012) A Japanese adult case of megalencephalic leukoencephalopathy with subcortical cysts with a good long-term prognosis. Intern Med 51(5):503–506

    Article  CAS  PubMed  Google Scholar 

  32. Uggetti C, La Piana R, Orcesi S, Egitto MG, Crow YJ, Fazzi E (2009) Aicardi–Goutieres syndrome: neuroradiologic findings and follow-up. AJNR Am J Neuroradiol 30(10):1971–1976

    Article  CAS  PubMed  Google Scholar 

  33. Barkovich A (2005) Infection of the nervous system. In: AJ B (ed) Pediatric neuroimaging. Lippincott Williams & Wilkins, Philadelphia, pp 801–868

    Google Scholar 

  34. Aicardi J, Goutieres F (1984) A progressive familial encephalopathy in infancy with calcifications of the basal ganglia and chronic cerebrospinal fluid lymphocytosis. Ann Neurol 15(1):49–54. doi:10.1002/ana.410150109

    Article  CAS  PubMed  Google Scholar 

  35. Aicardi J (2002) Aicardi–Goutieres syndrome: special type early-onset encephalopathy. Eur J Paediatr Neurol 6(Suppl A):A1–A7, discussion A23-25, A77-86

    Article  PubMed  Google Scholar 

  36. Lanzi G, Fazzi E, D'Arrigo S (2002) Aicardi–Goutieres syndrome: a description of 21 new cases and a comparison with the literature. Eur J Paediatr Neurol 6(Suppl A):A9–A22

    Article  PubMed  Google Scholar 

  37. Lopez-Hernandez T, Sirisi S, Capdevila-Nortes X, Montolio M, Fernandez-Duenas V, Scheper GC, van der Knaap MS, Casquero P, Ciruela F, Ferrer I, Nunes V, Estevez R (2011) Molecular mechanisms of MLC1 and GLIALCAM mutations in megalencephalic leukoencephalopathy with subcortical cysts. Hum Mol Genet 20(16):3266–3277

    Article  CAS  PubMed  Google Scholar 

  38. Batla A, Pandey S, Nehru R (2011) Megalencephalic leukoencephalopathy with subcortical cysts: a report of four cases. J Pediatr Neurosci 6(1):74–77

    PubMed Central  PubMed  Google Scholar 

  39. Bertini EE, D'Amico AA, Gualandi FF, Petrini SS (2011) Congenital muscular dystrophies: a brief review. Semin Pediatr Neurol 18(4):12–12. doi:10.1016/j.spen.2011.10.010

    Article  Google Scholar 

  40. van Engelen BG, Leyten QH, Bernsen PL, Gabreels FJ, Barkhof F, Joosten EM, Hamel BC, ter Laak HJ, Ruijs MB, Cruysberg JR et al (1992) Familial adult-onset muscular dystrophy with leukoencephalopathy. Ann Neurol 32(4):577–580. doi:10.1002/ana.410320415

    Article  PubMed  Google Scholar 

  41. Leite CC, Lucato LT, Martin MG, Ferreira LG, Resende MB, Carvalho MS, Marie SK, Jinkins JR, Reed UC (2005) Merosin-deficient congenital muscular dystrophy (CMD): a study of 25 Brazilian patients using MRI. Pediatr Radiol 35(6):572–579. doi:10.1007/s00247-004-1398-y

    Article  PubMed  Google Scholar 

  42. Barkovich AJ (1998) Neuroimaging manifestations and classification of congenital muscular dystrophies. AJNR Am J Neuroradiol 19(8):1389–1396

    CAS  PubMed  Google Scholar 

  43. van der Knaap MS, Smit L, Barth PG, Catsman-Berrevoets CE, Brouwer OF, Begeer JH, De Coo I, Valk J (1997) Magnetic resonance imaging in classification of congenital muscular dystrophies with brain abnormalities. Annals of neurology 42(1):50–59

    Article  PubMed  Google Scholar 

  44. Barkovich AJ (2012) Developmental disorders of the midbrain and hindbrain. Front Neuroanat 6:7. doi:10.3389/fnana.2012.00007

    Article  PubMed Central  PubMed  Google Scholar 

  45. Aida N, Tamagawa K, Takada K, Yagishita A, Kobayashi N, Chikumaru K, Iwamoto H (1996) Brain MR in Fukuyama congenital muscular dystrophy. AJNR Am J Neuroradiol 17(4):605–613

    CAS  PubMed  Google Scholar 

  46. Lo CP, Chen CY (2008) Neuroimaging of viral infections in infants and young children. Neuroimaging Clin N Am 18(1):119–132

    Article  PubMed  Google Scholar 

  47. Faria EC, Arita JH, Peruchi MM, Lin J, Masruha MR, Vilanova LC (2008) Cystic leukoencephalopathy without megalencephaly. Arq Neuropsiquiatr 66(2A):261–263

    Article  PubMed  Google Scholar 

  48. Henneke M, Preuss N, Engelbrecht V, Aksu F, Bertini E, Bibat G, Brockmann K, Hübner C, Mayer M, Mejaski-Bosnjak V (2005) Cystic leukoencephalopathy without megalencephaly: a distinct disease entity in 15 children. Am Acad Neurol 64(8):1411–1416

    CAS  Google Scholar 

  49. Henneke M, Diekmann S, Ohlenbusch A, Kaiser J, Engelbrecht V, Kohlschütter A, Krätzner R, Madruga-Garrido M, Mayer M, Opitz L, Rodriguez D, Rüschendorf F, Schumacher J, Thiele H, Thoms S, Steinfeld R, Nürnberg P, Gärtner J (2009) RNASET2-deficient cystic leukoencephalopathy resembles congenital cytomegalovirus brain infection. Nat Genet 41(7):773–775. doi:10.1038/ng.398

    Article  CAS  PubMed  Google Scholar 

  50. Wright R, Johnson D, Neumann M, Ksiazek TG, Rollin P, Keech RV, Bonthius DJ, Hitchon P, Grose CF, Bell WE, Bale JF Jr (1997) Congenital lymphocytic choriomeningitis virus syndrome: a disease that mimics congenital toxoplasmosis or cytomegalovirus infection. Pediatrics 100(1):E9

    Article  CAS  PubMed  Google Scholar 

  51. Vivarelli R, Grosso S, Cioni M, Galluzzi P, Monti L, Morgese G, Balestri P (2001) Pseudo-TORCH syndrome or Baraitser–Reardon syndrome: diagnostic criteria. Brain Dev 23(1):18–23

    Article  CAS  PubMed  Google Scholar 

Download references

Ethical standards and patient consent

We declare that all human and animal studies have been approved by the Santa Casa de Sao Paulo Medical Ethical Committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Renato Hoffmann Nunes.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Fig7

Supplementary online figure (cluster analysis). To determine the optimal number of clusters from the resulting dendrogram, two external validation measures (adjusted Rand index and normalised mutual information) were calculated for 1–23 (the largest number considered reasonable) clusters. Eleven clusters resulted in the highest discriminative indices (dotted line). (GIF 21 kb)

High resolution image (TIFF 843 kb)

234_2014_1356_MOESM2_ESM.xls

Supplementary online table. The clinical features (e.g., head size), location and distribution of additional imaging abnormalities (XLS 41 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nunes, R.H., Pacheco, F.T. & da Rocha, A.J. Magnetic resonance imaging of anterior temporal lobe cysts in children: discriminating special imaging features in a particular group of diseases. Neuroradiology 56, 569–577 (2014). https://doi.org/10.1007/s00234-014-1356-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-014-1356-9

Keywords

Navigation