Öz
Introduction: Neurofibromatosis type-1 is a genetically
transmitted neuro cutaneous syndrome. ADC technique is one of the accepted diagnostic
techniques in understanding the microstructural anomalies of the NF-1 disease.
In this study, our aim was to evaluate the lesions of NF-1 diagnosed child
patients, who underwent to brain MRI, with the use of the ADC valued imaging
technique.
Material and
Method: Diffusion weighted images and conventional sequences
of children, who have been monitored with NF-1 diagnosis in our clinic and
underwent brain MRI between 2010 January and 2015 June, were evaluated. Totally
89 lesions of 53 patients (21 women, 32 men), (age: 9,75±4.05) were
investigated. 24 healthy volunteers were also added to the study. Lesions were
investigated by dividing into four groups according to their locations and the mean
ADC value was measured for each group. The locations of the lesions were
determined as dentate nucleus, thalamus, basal ganglions and brain stem.
Results: The number of the lesions were 32 in the dentate
nucleus, 34 in the basal ganglion level, 10 in the brain stem and 13 in the
thalamus. The mean ADC values of undefined bright objects (UBOs) located at the
dentate nucleus, thalamus, basal ganglions and brain stem were higher than the
control group. The ones with the highest ADC values were in the basal ganglion
level, and the ones with the lowest ADC values were in the thalamus. The lesions
with the highest lesion diameter were in the thalamus (9,17 ±0,47mm) and the
smallest ones were in the brainstem (6.5±0.56mm). There was a statistically significant
difference between the ADC values of UBOs located at the supra (n=47) and infratentorial
(n=42) regions.
Discussion: Determination of the mean ADC values according
to the localizations will contribute to other studies which will done with
diffusion technique.in NF-1 patients.
Kaynakça
- Referans[1] Alkan A, Sigirci A, Kutlu R, Ozcan H, Erdem G, Aslan M, et al. Neurofibromatosis type 1: Diffusion weighted imaging findings of brain. Eur J Radiol 2005;56:229–34. doi:10.1016/j.ejrad.2005.05.008.
- Referans[2] Ferraz-Filho JRL, Da Rocha AJ, Muniz MP, Souza AS, Goloni-Bertollo EM, Pavarino-Bertelli ÉC. Diffusion tensor MR imaging in neurofibromatosis type 1: Expanding the knowledge of microstructural brain abnormalities. Pediatr Radiol 2012;42:449–54. doi:10.1007/s00247-011-2274-1.
- Referans[3] Hui ES, Cheung MM, Chan KC, Wu EX. B-value dependence of DTI quantitation and sensitivity in detecting neural tissue changes. Neuroimage 2010;49:2366–74. doi:10.1016/j.neuroimage.2009.10.022.
- Referans[4] Tognini G, Ferrozzi F, Garlaschi G, Piazza P, Patti A, Virdis R, et al. Brain apparent diffusion coefficient evaluation in pediatric patients with neurofibromatosis type 1. J Comput Assist Tomogr 2005;29:298–304. doi:10.1097/01.rct.0000162406.71300.b7.
- Referans[5] Kraut M a, Gerring JP, Cooper KL, Thompson RE, Denckla MB, Kaufmann WE. Longitudinal evolution of unidentified bright objects in children with neurofibromatosis-1. Am J Med Genet A 2004;129A:113–9. doi:10.1002/ajmg.a.20656.
- Referans[6] Van Engelen SJPM, Krab LC, Moll HA, De Goede-Bolder A, Pluijm SMF, Catsman-Berrevoets CE, et al. Quantitative differentiation between healthy and disordered brain matter in patients with neurofibromatosis type I using diffusion tensor imaging. Am J Neuroradiol 2008;29:816–22. doi:10.3174/ajnr.A0921.
- Referans[7] Barbier C, Chabernaud C, Barantin L, Bertrand P, Sembely C, Sirinelli D, et al. Proton MR spectroscopic imaging of basal ganglia and thalamus in neurofibromatosis type 1: Correlation with T2 hyperintensities. Neuroradiology 2011;53:141–8. doi:10.1007/s00234-010-0776-4.
- Referans[8] Karlsgodt KH, Rosser T, Lutkenhoff ES, Cannon TD, Silva A, Bearden CE. Alterations in White Matter Microstructure in Neurofibromatosis-1. PLoS One 2012;7:1–11. doi:10.1371/journal.pone.0047854.
- [Referans9] Filippi CG, Watts R, Duy LAN, Cauley KA. Diffusion-tensor imaging derived metrics of the corpus callosum in children with neurofibromatosis type I. Am J Roentgenol 2013;200:44–9. doi:10.2214/AJR.12.9590.
- Referans[10] Billiet T, Burkhard M, Arco FD, Peeters R, Deprez S, Sunaert S, et al. NeuroImage : Clinical Characterizing the microstructural basis of “ unidentified bright objects ” in neurofibromatosis type 1 : A combined in vivo multicomponent T2 relaxation and multi-shell diffusion MRI analysis. Neuroimage 2014;4:649–58. doi:10.1016/j.nicl.2014.04.005.
- Referans[11] Filippi CG, Watts R, Duy L a N, Cauley K a. Diffusion-tensor imaging derived metrics of the corpus callosum in children with neurofibromatosis type I. Am J Roentgenol 2013;200:44–9. doi:10.2214/AJR.12.9590.
- Referans [12] Hernáiz Driever P, Von Hornstein S, Pietsch T, Kortmann R, Warmuth-Metz M, Emser A, et al. Natural history and management of low-grade glioma in NF-1 children. J Neurooncol 2010;100:199–207. doi:10.1007/s11060-010-0159-z.
Nörofibromatozis tip-1 tanısı ile takip edilen hastalarda beyin dokusunda tanımlanan lezyonların değerlendirilmesinde ADC ağırlıklı görüntülemenin tanıdaki yeri :
Öz
Giriş Nörofibromatozis tip -1
genetik geçiş gösteren nörokutanöz bir sendromdur. ADC tekniği ise NF-1 hastalığındaki
mikroyapısal anormalliklerin anlaşılmasında kabul edilen tanı yöntemlerindendir. Bu çalışmada
amacımız NF-1 tanısı ile beyin MRG çekilen çocuk
hastalardaki lezyonların ADC ağırlıklı görüntüleme tekniği ile
değerlendirilmesi
Materyal-method: Kliniğimize Ocak 2010–Haziran 2015 tarihleri arasında
NF-1 tanısı ile takip edilen ve beyin MRI çekilen çocuk hastaların difüzyon ağırlıklı görüntüleri ve konvansiyonel sekansları değerlendirilmiştir.
Çalışmada 53 adet hastanın (21 kadın, 32 erkek), (yaş: 9,75±4.05) 89 adet
lezyonu incelenmiştir. 24 adet sağlıklı bireyin beyin MR si incelenerek kontrol
grubu oluşturulmuştur. Lezyonlar lokalizasyonlarına göre dört gruba ayrılarak incelenmiş olup her bir grup
için mean ADC değerleri ölçülmüştür.
Lezyon lokalizasyonları dentat nükleus, talamus, bazal ganglion, beyin sapı
olarak belirlenmiştir.
Bulgular: Lezyon sayısı dentat nukleusta 32, bazal
ganglion düzeyinde 34, beyin sapı için 10 adet, talamus için 13 adettir. Dentat
nükleus, talamus, bazal ganglion, beyin sapı UBO’ (undefined
bright object) lardaki ADC değerleri kontrol grubu ile kıyaslandığında belirgin
olarak yüksek bulunmuştur. ADC değerleri en yüksek olanlar bazal ganglianlar düzeyinde
iken, en düşük olanlar talamus lokalizasyondadır. Lezyon çapı en büyük olanlar talamusta iken (9,17 ±0,47 mm) en küçük olanlar beyin sapı düzeyinde (6.5±0.56 mm) dir. Supra (n=47) ve infratentoriyal (n=42) UBO’ların ADC
değerleri arasında istatistiksel olarak belirgin bir fark bulunmaktadır.
Tartışma: NF-1 hastalarının mean ADC değerlerinin lokalizasyonlara göre değerlerinin
belirlenmesi difüzyon tekniği ile yapılacak diğer çalışmalara da katkıda bulunacaktır.
Kaynakça
- Referans[1] Alkan A, Sigirci A, Kutlu R, Ozcan H, Erdem G, Aslan M, et al. Neurofibromatosis type 1: Diffusion weighted imaging findings of brain. Eur J Radiol 2005;56:229–34. doi:10.1016/j.ejrad.2005.05.008.
- Referans[2] Ferraz-Filho JRL, Da Rocha AJ, Muniz MP, Souza AS, Goloni-Bertollo EM, Pavarino-Bertelli ÉC. Diffusion tensor MR imaging in neurofibromatosis type 1: Expanding the knowledge of microstructural brain abnormalities. Pediatr Radiol 2012;42:449–54. doi:10.1007/s00247-011-2274-1.
- Referans[3] Hui ES, Cheung MM, Chan KC, Wu EX. B-value dependence of DTI quantitation and sensitivity in detecting neural tissue changes. Neuroimage 2010;49:2366–74. doi:10.1016/j.neuroimage.2009.10.022.
- Referans[4] Tognini G, Ferrozzi F, Garlaschi G, Piazza P, Patti A, Virdis R, et al. Brain apparent diffusion coefficient evaluation in pediatric patients with neurofibromatosis type 1. J Comput Assist Tomogr 2005;29:298–304. doi:10.1097/01.rct.0000162406.71300.b7.
- Referans[5] Kraut M a, Gerring JP, Cooper KL, Thompson RE, Denckla MB, Kaufmann WE. Longitudinal evolution of unidentified bright objects in children with neurofibromatosis-1. Am J Med Genet A 2004;129A:113–9. doi:10.1002/ajmg.a.20656.
- Referans[6] Van Engelen SJPM, Krab LC, Moll HA, De Goede-Bolder A, Pluijm SMF, Catsman-Berrevoets CE, et al. Quantitative differentiation between healthy and disordered brain matter in patients with neurofibromatosis type I using diffusion tensor imaging. Am J Neuroradiol 2008;29:816–22. doi:10.3174/ajnr.A0921.
- Referans[7] Barbier C, Chabernaud C, Barantin L, Bertrand P, Sembely C, Sirinelli D, et al. Proton MR spectroscopic imaging of basal ganglia and thalamus in neurofibromatosis type 1: Correlation with T2 hyperintensities. Neuroradiology 2011;53:141–8. doi:10.1007/s00234-010-0776-4.
- Referans[8] Karlsgodt KH, Rosser T, Lutkenhoff ES, Cannon TD, Silva A, Bearden CE. Alterations in White Matter Microstructure in Neurofibromatosis-1. PLoS One 2012;7:1–11. doi:10.1371/journal.pone.0047854.
- [Referans9] Filippi CG, Watts R, Duy LAN, Cauley KA. Diffusion-tensor imaging derived metrics of the corpus callosum in children with neurofibromatosis type I. Am J Roentgenol 2013;200:44–9. doi:10.2214/AJR.12.9590.
- Referans[10] Billiet T, Burkhard M, Arco FD, Peeters R, Deprez S, Sunaert S, et al. NeuroImage : Clinical Characterizing the microstructural basis of “ unidentified bright objects ” in neurofibromatosis type 1 : A combined in vivo multicomponent T2 relaxation and multi-shell diffusion MRI analysis. Neuroimage 2014;4:649–58. doi:10.1016/j.nicl.2014.04.005.
- Referans[11] Filippi CG, Watts R, Duy L a N, Cauley K a. Diffusion-tensor imaging derived metrics of the corpus callosum in children with neurofibromatosis type I. Am J Roentgenol 2013;200:44–9. doi:10.2214/AJR.12.9590.
- Referans [12] Hernáiz Driever P, Von Hornstein S, Pietsch T, Kortmann R, Warmuth-Metz M, Emser A, et al. Natural history and management of low-grade glioma in NF-1 children. J Neurooncol 2010;100:199–207. doi:10.1007/s11060-010-0159-z.
Ayrıntılar
| Konular | Klinik Tıp Bilimleri |
|---|---|
| Bölüm | ARAŞTIRMA MAKALESİ |
| Yazarlar | |
| Yayımlanma Tarihi | 18 Aralık 2017 |
| Yayımlandığı Sayı | Yıl 2017 Cilt: 1 Sayı: 3 |
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