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. 2022 Jul 7;13(1):115.
doi: 10.1186/s13244-022-01219-2.

Synthetic MRI in children with tuberous sclerosis complex

Gokcen Coban  1 , Ekim Gumeler  2 , Safak Parlak  2 , Bahadir Konuskan  3 , Jale Karakaya  4 , Dilek Yalnizoglu  3 , Banu Anlar  3 , Kader K Oguz  2
Affiliations

Synthetic MRI in children with tuberous sclerosis complex

Gokcen Coban et al. Insights Imaging. .

Abstract

Objective: The generation of numerous sequences and quantitative data in a short scanning time is the most potential advantage of Synthetic MRI (SyMRI). We aimed to test detection of the tubers and to determine underlying tissue characteristics, and morphometric alterations in the brain of pediatric tuberous sclerosis complex (TSC) patients, using SyMRI.

Methods: Conventional brain MRI (cMRI) and SyMRI were prospectively obtained from 10 TSC patients and 18 healthy control subjects (HCs). Two neuroradiologists independently evaluated tubers on both scans. Additionally, automatically segmented volume calculation and myelin quantification, including the subcortical part of the tubers and normal-appearing brain parenchyma (NABP) of patients, were carried out using SyMRI.

Results: The cMRI and SyMRI comparison showed a very good correlation on the detection of the tubers (k = 0.82-0.94). Automatic segmentation of Non-gray matter/white matter/cerebrospinal fluid (Non), %Non/brain parenchymal volume, and %Non/intracranial volume was significantly higher; however, %Myelin/intracranial volume and %Myelin/brain parenchymal volume were significantly lower in the TSC patients (p < 0.05). The proton density values were significantly increased, and myelin fraction volume and myelin-correlated compound values were significantly decreased in the NABP in TSC patients on myelin maps (p < 0.05). The white-matter volume, myelin and white-matter fractional volume, longitudinal relaxation rate, transverse relaxation rate, and myelin-correlated compound values were significantly decreased in the subcortical part of tubers on quantification maps (p < 0.001) in TSC patients.

Conclusion: SyMRI enables the detection of cortical tubers and is a developing tool in the quantification of morphometric and tissue alterations in pediatric TSC patients with a rational scanning time.

Keywords: Subcortical radial bands; Subependymal nodules; Synthetic MRI; Tuberous sclerosis; Tubers.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Synthetic (Sy) T2-weighted (B) and Sy-FLAIR (D) images show cortical/subcortical tubers accurately as on the conventional T2W (A) and FLAIR (C) images
Fig. 2
Fig. 2
Images of 10-year-old patients with TSC. Subcortical tuber in the frontal lobe (A, white arrow) is seen on the axial FLAIR image. Myelin maps (B and C) show prominently decreased R1, R2, PD, MyC, and MyCvol values on the left side (B, red ROI) compared with the normal side (C, red ROI). Also, the myelin map does not assign the tuber as green like in other myelinated areas
Fig. 3
Fig. 3
Myelin (A, B), WM (C), and GM (D) segmentation maps of a TSC patient. The subcortical part of the tuber on the right parietal white matter (A, red ROI) shows prominently decreased R1, R2, PD, MyC, and MyCvol values compared to the normal right side (B, red ROI). WM map (C) does not mark the subcortical tubers as WM. However, GM map (D) marks the subcortical tubers as GM
See this image and copyright information in PMC

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