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Magnetization transfer technique improving magnetic
resonance evidence of cerebral tuberous sclerosis
in a 9-month-old infant

Paolo Galluzzi, Alfonso Cerase, Gabriella Bartalini, Paolo Balestri, Carlo Venturi

CaseRepClinPractRev 2002; 3(4):224-229

ID: 474436

Background: Intracranial lesions are the most important factors determining clinical outcome of patients with tuberous sclerosis complex. Magnetic resonance imaging is considered the method of choice for the identification
of such intracranial lesions. However, their appearance at conventional magnetic resonance imaging changes with myelination. Actually, as myelination proceeds, signal intensities of gray and white matter start to reverse at approximately 6 months of age resulting in diminished sensitivity of magnetic resonance imaging. Magnetization tranfer is a tissue-suppression technique improving image contrast in magnetic resonance imaging by
suppression of background normal brain tissue. The usefulness of magnetization transfer for the assessment of tuberous sclerosis complex intracranial manifestations has been clearly demonstrated, although the information about its use in children of £2 years of age is scanty.
Case report: The purpose of this report is to present a 9-month-old female with tuberous sclerosis complex, in whom unenhanced magnetization transfer T1-weighted images allowed the documentation of several tubers in
both cerebral hemispheres, whilst conventional magnetic resonance imaging including fast-fluid-attenuated-inversion- recovery sequence showed only two right frontal tubers.
Conclusion: Between the sixth month of life and complete white matter maturation, conventional magnetic resonance imaging may not show all intracranial lesions due to tuberous sclerosis complex: for a thorough depiction
of intracranial manifestations, magnetization transfer should be added to conventional magnetic resonance sequences also in children £2 years of age.

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