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