Subependymal giant cell astrocytoma with high choline/creatine ratio on proton MR spectroscopy

Arquivos de Neuro-Psiquiatria

Arnolfo De Carvalho Neto²  Emerson L. Gasparetto¹  Isac Bruck¹ 

[1] ,University of Parana School of Medicine Departments of Diagnostic Radiology

关键词: subependymal giant cell astrocytoma;    proton magnetic resonance spectroscopy;    tuberous sclerosis;    astrocitoma subependimário de células gigantes;    espectroscopia de prótons por ressonância magnética;    esclerose tuberosa;   

DOI  :  10.1590/S0004-282X2006000500033

来源: SciELO

【 摘 要 】

OBJECTIVE: To report a case of subependymal giant cell astrocytoma (SEGA) in a patient with tuberous sclerosis, emphasizing the proton MR spectroscopy (MRS) findings. CASE: A three year-old boy with tuberous sclerosis presented with a 3-month history of mild headache. The physical examination showed discrete mental retardation and multiple hypomelanic macules in the legs and back. MRI showed many cortical tubers and subependymal nodules. At the left foramen of Monro, there was a 15 mm nodule, with heterogeneous signal on T1 and T2-weighted images, and strong enhancement after contrast administration. MRS study (multi-voxel PRESS, TE=144ms) showed the following ratios: a) left foramen of Monro nodule N-acetylaspartate (NAA)/creatine (Cr)=0.93 and Choline (Cho)/Cr=1.6 and b) at the right Monro foramen NAA/Cr=1.56 and Cho/Cr=1.29. CONCLUSION: The MRS performed at the SEGA may show high Cho/Cr and low NAA/Cr ratios, similar to the other brain neoplasms. As a consequence, MRS may be a valuable tool for the early detection of neoplastic transformation of subependymal nodules near the foramina of Monro in patients with tuberous sclerosis.

【 授权许可】

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