Axial T2-weighted (image 1) and susceptibility-weighted (ima | Figure 1
CincyKidsRad
Cincinnati Children's Radiology
Axial T2-weighted (image 1) and susceptibility-weighted (image 2) images show subcortical white matter anomalies (also known as tubers; arrow, image 1) and calcification with susceptibility artifact of one of the subependymal nodules (arrow, image 2). The imaging findings are consistent with tuberous sclerosis. Other neuroimaging findings of tuberous sclerosis include subependymoma giant cell astrocytoma, radial migration lines, and microcephaly. Heterotopic gray matter can also cause subependymoma nodularity. #FridayQuizDay #FridayQuiz
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Axial T1 FLAIR MRI shows subependymal gray matter heterotopia (arrowhead), the most commonly observed form of gray matter heterotopia. The differential diagnosis for this finding includes subependymal nodules that occur in tuberous sclerosis complex. Gray matter heterotopia is distinguished from subependymal nodules of tuberous sclerosis by the signal intensity of the nodule; in tuberous sclerosis, the T2 signal of subependymal nodules is higher than that of normal gray matter while nodules in gray matter heterotopia are isointense to gray matter. Patients with tuberous sclerosis may also have additional stigmata such as subcortical tubers and subependymal giant cell astrocytomas.
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