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Magnetic resonance imaging of tuberous sclerosis complex with or without epilepsy at 7 T

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Purpose

This study was conducted to determine the benefit of magnetic resonance imaging (MRI) at 7 T in detecting structural lesions and previously unidentified abnormalities in patients with tuberous sclerosis complex (TSC).

Methods

Thirteen patients with TSC (8–36 years, seven males) previously diagnosed by 3 T MRI underwent additional imaging at 7 T, which included T1-weighted magnetization-prepared rapid gradient-echo (MPRAGE), T2-weighted turbo spin echo (TSE), SPACE fluid attenuated inversion recovery (FLAIR), susceptibility weighted imaging (SWI), white matter suppressed (WM-suppressed), and gray-white matter tissue border enhancement (GW-TBE) MPRAGE sequences. Subtle lesions, tuberal morphology, and perituberal cortex abnormalities were examined and compared to those observed at 3 T MRI using standard sequences.

Results

Improved visualization of TSC lesions was achieved in all subjects at 7 T compared to 3 T imaging, and three subjects received resective surgery. The 7 T T1- and T2-weighted images had high spatial resolution and provided a clear delineation of the perituberal cortex. SWI revealed abnormal blood vessel morphology. WM-suppressed and GW-TBE protocols, adjusted specifically for TSC imaging, aided in visualizing lesions and uncovered more extensive subtle lesions and abnormalities beyond the conventionally detected tubers.

Conclusions

Due to its high spatial resolution and powerful new imaging protocols, 7 T MRI provided a better evaluation of subtle lesions and perituberal details compared with conventional MRI at 3 T, with potential implications for diagnosis and operative treatment of TSC and its related epilepsy.

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Abbreviations

TSC:

Tuberous sclerosis complex

MPRAGE:

Magnetization-prepared rapid gradient-echo

FLAIR:

Fluid attenuated inversion recovery

SWI:

Susceptibility weighted imaging

WM-suppressed:

White matter suppressed

GW-TBE:

Gray-white matter tissue border enhancement

TSE:

Turbo spin echo

SNR:

Signal-to-noise ratio

EEG:

Electroencephalography

PET:

Positron emission computed tomography

SEEG:

Stereotactic intracranial EEG

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Acknowledgements

We thank the patients and their family members for their cooperation during examination and follow-ups. We would also like to thank Ms. Jing An (Simens Shenzhen MR Ltd.), Ms. Kun Hu and Ms. Ziwei Cheng for their technical assistance in MR experiments and valuable discussions.

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Author notes

    Authors and Affiliations

    1. State Key Laboratory of Brain and Cognitive Science, Beijing MRI Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, 15 Datun Road, Chaoyang District, Beijing, 100101, China

      Kaibao Sun, Bo Wang, Zhongwei Chen, Fei Cong, Yan Zhuo, Rong Xue & Lin Chen

    2. University of Chinese Academy of Sciences, Beijing, 100049, China

      Kaibao Sun, Fei Cong, Rong Xue & Lin Chen

    3. Neurosurgery Department, First Affiliated Hospital of PLA General Hospital, Beijing, 100853, China

      Jianfei Cui & Shuli Liang

    4. Neurosurgery Department, PLA General Hospital, Beijing, 100048, China

      Jianfei Cui, Shuli Liang & Xinguang Yu

    5. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China

      Tao Jiang

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    1. Kaibao Sun
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    Correspondence to Shuli Liang or Rong Xue.

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    Funding

    This study was funded in part by the Ministry of Science and Technology of China (MOST) (Grant no. 2015CB351701), the National Nature Science Foundation of China (Grant nos. 31730039 and 81771388) and the Chinese Academy of Sciences Strategic Priority Research Program B (Grant nos. XDB02010001 and XDB02050001).

    Conflict of interest

    The authors declare that they have no conflict of interest.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

    Informed consent

    Informed consent was obtained from all individual participants included in the study.

    Additional information

    KS and JC are joint first authors and contributed equally to this study.

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    Sun, K., Cui, J., Wang, B. et al. Magnetic resonance imaging of tuberous sclerosis complex with or without epilepsy at 7 T. Neuroradiology 60, 785–794 (2018). https://doi.org/10.1007/s00234-018-2040-2

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