867 0361 -803X/92/1 584-0867 0 American Roentgen Ray Society Diagnosis of Sturge-Weber Syndrome: Comparison of the Efficacy of CT and MR Imaging in 14 Cases Luis MartI-BonrnatV Francisco Menor Cecilio Poyato& Hector Cortina2 Sturge-Weber syndrome is a neurocutaneous syndrome that includes facial and leptomeningeal angiomas. Imaging findings include cerebral lobar atrophy, brain calci- fications, choroid plexus enlargement, cranial diplo#{235} prominence, and venous abnor- malities. We compared the efficacy of CT and MR imaging in making the diagnosis in 14 consecutive patients. CT, with and without contrast enhancement, was performed in all patients, and 11 of the 14 had MR imaging (eight before and after administration of IV gadopentetate dimeglumine). MR imaging was better than CT in showing the extent and degree of brain parenchymal atrophy, the presumed ischemic changes affecting the gray and white matter, and the cranial diploetic prominence on the affected side. MR imaging after contrast administration permitted a better evaluation of the extent and patency of the leptomeningeal angiomatous malformation and the parenchymal venous anomalies. CT was better than MR imaging in showing the presence and extent of cortical calcifications. Enhanced CT and MR imaging were equal in evaluating the prominence of the ipsilateral choroid plexus. Our experience indicates that contrast-enhanced MR imaging is the method of choice in the diagnosis of Sturge-Weber syndrome. Unenhanced CT should be used only if MR findings are normal, to exclude the presence of intracranial calcifications. AJR 158:867-871, April 1992 Sturge-Weber syndrome (encephalotrigeminal angiomatosis) is a neurocuta- neous syndrome seen in children that is characterized by leptomeningeal angio- matosis and an ipsilateral facial nevus in the area of the trigeminal nerve, involving at least its ophthalmic division. CT has been the imaging method of choice in patients with this disorder [1 , 2], but recently MR imaging also has been used [2- 5]. In this study, we compared the efficacy of enhanced and unenhanced CT and MA imaging in the diagnosis of the Sturge-Weber syndrome in 1 4 cases. Subjects and Methods Received July 19, 1991 ; accepted after revision October 30, 1991. I Unidad de Resonancia Magn#{233}tica, Departa- mento de Diagn#{244}stico per Ia Imagen, Hospital Dr Peset, E-46017 Valencia, Spain. Address reprint requests to L. Marti-BonmatI. 2 Servicio de Radiodiagn#{244}stico, Hospital Infantil La Fe, Valencia, Spain. Fourteen consecutive children with Sturge-Weber syndrome were included in the study. The nine boys and five girls were 2-21 years old (mean, 10 years; SD, 5 years). Only one patient had a family history of the disease. All patients had the characteristic facial angioma. This was ipsilateral to the hemispheric lesions in 12 cases, bilateral in one with a left-sided leptomeningeal angiomatosis, and contralateral to the Ieptomeningeal angiomatosis in another patient. CT was performed in all 14 cases (General Electric 9800, Milwaukee, WI, and Toshiba TCT-600HQ, Nasu, Japan) without and with IV contrast agents. A bolus of contrast medium was injected by hand, a volume of 2-3 mI/kg of a 300 mg I/mI solution (Omnitrast 300, Schenng AG, Berlin, Germany). Slice thickness was 10 mm. Two successive studies were made in all cases, separated by an average of 5 years; only the second CT examination was considered in this study. MR imaging was performed in 1 1 children, all within 5 months of the second CT examina- tion. A 0.5-T unit (Philips Gyroscan S5, Eindhoven, the Netherlands) was used. All patients Downloaded from www.ajronline.org by 171.243.65.178 on 05/15/23 from IP address 171.243.65.178. Copyright ARRS. For personal use only; all rights reserved
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