Tuberosklerozda İntrakranyal Lezyonların Difüzyon Tensör Görüntüleme Bulguları

Amaç: Tuberoskleroz’lu (TSC) olgularda kortikal/subkortikal yerleşimli tuberler ile beyaz cevher lezyonlarının (BCL) normal görünen karşı serebral hemisfer (NGP) ve korpus kallozum genu (KKG) ile KK splenium (KKS), ADC (görünür difüzyon katsayısı) ve FA (fraksiyonel anizotropi) değerleri açısından farklılık gösterip göstermediğini ve aralarındaki korelasyonu araştırmayı amaçladık. Gereç ve Yöntemler: TSC’li 23 olgunun beyin MRG ve DTG (Difüzyon Tensör Görüntüleme) bulguları geriye dönük olarak değerlendirildi. Tuberler, BCL, NGP, KKG ve KKS’nin ADC ve FA değerleri ölçülerek karşılaştırıldı. Bulgular: Tuber ve BCL’nin ADC değerleri, NGP, KKG ve KKS’a göre belirgin yüksek izlenirken, FA değerlerinde azalma saptandı (Herbiri için; p= 0.001). Tuber ADC değerleri ile KKS FA değerleri arasında negatif korelasyon mevcuttu (p=0.003, r= -0.304). BCL’nin FA değerleri ile KKS ADC değerleri arasında negatif korelasyon saptandı (p=0.02, r= -0.395). Sonuç: TSC’li olgularda ADC ve FA değerlerindeki değişiklikler hamartomatöz proliferasyona ve miyelin kılıf bozukluklarına bağlı yapısal değişikliklerle açıklanabilir. DTG, TSC’li olgularda beyin lezyonlarının oluşum mekanizmasını hücresel düzeyde daha iyi anlamamıza katkıda bulunacağı görüşündeyiz.

Diffusion Tensor Imaging Findings of Intracranial Lesions in Tuberous Sclerosis

Aim: To investigate whether there is a difference in ADC (apparent diffusion coefficient) and FA (fractional anisotropy) values between cortical / subcortical tubers, white matter lesions (WML) and normal appearing contralateral cerebral hemisphere (NAP) and corpus callosum (CC) in patients with Tuberous sclerosis (TSC) and the correlation between them. Material and Methods: Brain MRI and DTI (Diffusion Tensor Imaging) findings of 23 patients TSC were evaluated retrospectively. ADC and FA values of tubers, WML, NAP, CC genu (CCG) and splenium (CCS) were measured and compared. Results: While ADC values of tuber and WML were significantly higher than NAP, CCG and CCS, FA values were decreased (for each; p=0.001). There was a negative correlation between tuber ADC values and CCS FA values (p=0.003, r= -0.304). There was a negative correlation between FA values of WML and CCS ADC values (p=0.02, r= -0.395). Conclusion: Changes in ADC and FA values in patients with TSC can be explained by structural changes due to hamartomatous proliferation and myelin sheath disorders. We are of the opinion that DTI will contribute to our better understanding of the mechanism of brain lesions formation at the cellular level in patients with TSC.

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