EURORAD ESR

Case 2288

Abdominal involvement in tuberous sclerosis complex

Author(s)
Crocetti L, Cosottini M, Lencioni R
 
Patient
female, 34 year(s)
 
 
  • Figure 1
    Abdominal US
     

    Two round-shaped hyperechoic focal liver lesions were demonstrated in segments I and V. A solid hypoechoic focal lesion was depicted in both the right and left kidneys. Power Doppler examination of the larger...

     
    Area of Interest: unknown; Imaging Technique: Abdominal US;

    Two round-shaped hyperechoic focal liver lesions were demonstrated in segments I and V. A solid hypoechoic focal lesion was depicted in both the right and left kidneys. Power Doppler examination of the larger...

     
    Area of Interest: unknown; Imaging Technique: Abdominal US;

    Two round-shaped hyperechoic focal liver lesions were demonstrated in segments I and V. A solid hypoechoic focal lesion was depicted in both the right and left kidneys. Power Doppler examination of the larger...

     
    Area of Interest: unknown; Imaging Technique: Abdominal US;

    Two round-shaped hyperechoic focal liver lesions were demonstrated in segments I and V. A solid hypoechoic focal lesion was depicted in both the right and left kidneys. Power Doppler examination of the larger...

     
    Area of Interest: unknown; Imaging Technique: Abdominal US;
     
     
  • Figure 2
    Abdominal CT
     

    The liver lesions were hypodense, with negative densitometry values. The larger lesion had an internal area that became hyperdense during the portal-venous phase.

     
    Area of Interest: unknown; Imaging Technique: Abdominal CT;

    The liver lesions were hypodense, with negative densitometry values. The larger lesion had an internal area that became hyperdense during the portal-venous phase.

     
    Area of Interest: unknown; Imaging Technique: Abdominal CT;

    The liver lesions were hypodense, with negative densitometry values. The larger lesion had an internal area that became hyperdense during the portal-venous phase.

     
    Area of Interest: unknown; Imaging Technique: Abdominal CT;

    The liver lesions were hypodense, with negative densitometry values. The larger lesion had an internal area that became hyperdense during the portal-venous phase.

     
    Area of Interest: unknown; Imaging Technique: Abdominal CT;

    The liver lesions were hypodense, with negative densitometry values. The larger lesion had an internal area that became hyperdense during the portal-venous phase. The suggested diagnosis was of angiomyolipomas...

     
    Area of Interest: unknown; Imaging Technique: Abdominal CT;
     
     
  • Figure 3
    Abdominal CT
     

    The right renal lesion showed early intense enhancement during the arterial phase, and wash-out during the portal-venous and delayed phase. The left, smaller renal lesion showed only slight enhancement during...

     
    Area of Interest: unknown; Imaging Technique: Abdominal CT;

    The right renal lesion showed early intense enhancement during the arterial phase, and wash-out during the portal-venous and delayed phase. The left, smaller renal lesion showed only slight enhancement during...

     
    Area of Interest: unknown; Imaging Technique: Abdominal CT;

    The right renal lesion showed early intense enhancement during the arterial phase, and wash-out during the portal-venous and delayed phase. The left, smaller renal lesion showed only slight enhancement during...

     
    Area of Interest: unknown; Imaging Technique: Abdominal CT;

    The right renal lesion showed early intense enhancement during the arterial phase, and wash-out during the portal-venous and delayed phase. The left, smaller renal lesion showed only slight enhancement during...

     
    Area of Interest: unknown; Imaging Technique: Abdominal CT;

    The right renal lesion showed early intense enhancement during the arterial phase, and wash-out during the portal-venous and delayed phase. The left, smaller renal lesion showed only slight enhancement during...

     
    Area of Interest: unknown; Imaging Technique: Abdominal CT;

    The right renal lesion showed early intense enhancement during the arterial phase, and wash-out during the portal-venous and delayed phase. The left, smaller renal lesion showed only slight enhancement during...

     
    Area of Interest: unknown; Imaging Technique: Abdominal CT;
     
     
  • Figure 4
    Abdominal MRI
     

    The liver lesions appeared hyperintense on T1-weighted images with signal saturation in sequences with selective fat-sat pulse. After paramagnetic contrast agent administration, lesions showed similar...

     
    Area of Interest: unknown; Imaging Technique: Abdominal MRI;

    The liver lesions appeared hyperintense on T1-weighted images with signal saturation in sequences with selective fat-sat pulse. After paramagnetic contrast agent administration, lesions showed similar...

     
    Area of Interest: unknown; Imaging Technique: Abdominal MRI;
     
     
  • Figure 5
    Abdominal MRI
     

    The kidney lesions appeared isointense to renal medulla on T1-weighted images and hypointense on T2-weighted images. The hypointensity on T2-weighted images suggested a rich mesenchymal component, with poor...

     
    Area of Interest: unknown; Imaging Technique: Abdominal MRI;

    The kidney lesions appeared isointense to renal medulla on T1-weighted images and hypointense on T2-weighted images. The hypointensity on T2-weighted images suggested a rich mesenchymal component, with poor...

     
    Area of Interest: unknown; Imaging Technique: Abdominal MRI;

    The kidney lesions appeared isointense to renal medulla on T1-weighted images and hypointense on T2-weighted images. The hypointensity on T2-weighted images suggested a rich mesenchymal component, with poor...

     
    Area of Interest: unknown; Imaging Technique: Abdominal MRI;

    The kidney lesions appeared isointense to renal medulla on T1-weighted images and hypointense on T2-weighted images. The hypointensity on T2-weighted images suggested a rich mesenchymal component, with poor...

     
    Area of Interest: unknown; Imaging Technique: Abdominal MRI;
     
     
  • Figure 6
     

    No annotation

     
    Area of Interest: unknown;

    No annotation

     
    Area of Interest: unknown;

    No annotation

     
    Area of Interest: unknown;

    No annotation

     
    Area of Interest: unknown;
     
     
  • Figure 7
    Phenotypical stigmata

    Facial adenoma sebaceum.

     
    Area of Interest: unknown; Imaging Technique: Phenotypical stigmata;
     
     
  • Figure 8
    Brain MR and CT
     

    On FLAIR images, in the subcortical white matter, both wedge-shaped areas and curvilinear bands of hyperintensity were depicted; the latter extended from the ventricle through the cerebrum towards the cortex...

     
    Area of Interest: unknown; Imaging Technique: Brain MR and CT;

    No annotation

     
    Area of Interest: unknown; Imaging Technique: Brain MR and CT;

    No annotation

     
    Area of Interest: unknown; Imaging Technique: Brain MR and CT;

    No annotation

     
    Area of Interest: unknown; Imaging Technique: Brain MR and CT;

    No annotation

     
    Area of Interest: unknown; Imaging Technique: Brain MR and CT;

    No annotation

     
    Area of Interest: unknown; Imaging Technique: Brain MR and CT;
     
     
Two round-shaped hyperechoic focal liver lesions were demonstrated in segments I and V. A solid hypoechoic focal lesion was depicted in both the right and left kidneys. Power Doppler examination of the larger renal lesion showed the presence of intralesional flow signals.
 
Two round-shaped hyperechoic focal liver lesions were demonstrated in segments I and V. A solid hypoechoic focal lesion was depicted in both the right and left kidneys. Power Doppler examination of the larger renal lesion showed the presence of intralesional flow signals.
 
Two round-shaped hyperechoic focal liver lesions were demonstrated in segments I and V. A solid hypoechoic focal lesion was depicted in both the right and left kidneys. Power Doppler examination of the larger renal lesion showed the presence of intralesional flow signals.
 
Two round-shaped hyperechoic focal liver lesions were demonstrated in segments I and V. A solid hypoechoic focal lesion was depicted in both the right and left kidneys. Power Doppler examination of the larger renal lesion showed the presence of intralesional flow signals.
 
The liver lesions were hypodense, with negative densitometry values. The larger lesion had an internal area that became hyperdense during the portal-venous phase.
 
The liver lesions were hypodense, with negative densitometry values. The larger lesion had an internal area that became hyperdense during the portal-venous phase.
 
The liver lesions were hypodense, with negative densitometry values. The larger lesion had an internal area that became hyperdense during the portal-venous phase.
 
The liver lesions were hypodense, with negative densitometry values. The larger lesion had an internal area that became hyperdense during the portal-venous phase.
 
The liver lesions were hypodense, with negative densitometry values. The larger lesion had an internal area that became hyperdense during the portal-venous phase. The suggested diagnosis was of angiomyolipomas of the liver.
 
The right renal lesion showed early intense enhancement during the arterial phase, and wash-out during the portal-venous and delayed phase. The left, smaller renal lesion showed only slight enhancement during the arterial phase.
 
The right renal lesion showed early intense enhancement during the arterial phase, and wash-out during the portal-venous and delayed phase. The left, smaller renal lesion showed only slight enhancement during the arterial phase.
 
The right renal lesion showed early intense enhancement during the arterial phase, and wash-out during the portal-venous and delayed phase. The left, smaller renal lesion showed only slight enhancement during the arterial phase.
 
The right renal lesion showed early intense enhancement during the arterial phase, and wash-out during the portal-venous and delayed phase. The left, smaller renal lesion showed only slight enhancement during the arterial phase.
 
The right renal lesion showed early intense enhancement during the arterial phase, and wash-out during the portal-venous and delayed phase. The left, smaller renal lesion showed only slight enhancement during the arterial phase.
 
The right renal lesion showed early intense enhancement during the arterial phase, and wash-out during the portal-venous and delayed phase. The left, smaller renal lesion showed only slight enhancement during the arterial phase.
 
The liver lesions appeared hyperintense on T1-weighted images with signal saturation in sequences with selective fat-sat pulse. After paramagnetic contrast agent administration, lesions showed similar behaviour to that depicted by spiral CT.
 
The liver lesions appeared hyperintense on T1-weighted images with signal saturation in sequences with selective fat-sat pulse. After paramagnetic contrast agent administration, lesions showed similar behaviour to that depicted by spiral CT. The diagnosis was of angiomyolipomas of the liver.
 
The kidney lesions appeared isointense to renal medulla on T1-weighted images and hypointense on T2-weighted images. The hypointensity on T2-weighted images suggested a rich mesenchymal component, with poor cellularity. After paramagnetic contrast agent administration, the lesion showed similar behaviour to that depicted by spiral CT.
 
The kidney lesions appeared isointense to renal medulla on T1-weighted images and hypointense on T2-weighted images. The hypointensity on T2-weighted images suggested a rich mesenchymal component, with poor cellularity. After paramagnetic contrast agent administration, the lesion showed similar behaviour to that depicted by spiral CT.
 
The kidney lesions appeared isointense to renal medulla on T1-weighted images and hypointense on T2-weighted images. The hypointensity on T2-weighted images suggested a rich mesenchymal component, with poor cellularity. After paramagnetic contrast agent administration, the lesion showed similar behaviour to that depicted by spiral CT.
 
The kidney lesions appeared isointense to renal medulla on T1-weighted images and hypointense on T2-weighted images. The hypointensity on T2-weighted images suggested a rich mesenchymal component, with poor cellularity. After paramagnetic contrast agent administration, the lesion showed similar behaviour to that depicted by spiral CT. The diagnosis was of angiomyolipomas of the kidney. The different enhancement pattern of the two renal lesions was a consequence of different amounts of vascular, fatty, fibrous, and smooth muscle tissue within the lesions.
 
 
 
 
 
Facial adenoma sebaceum.
 
On FLAIR images, in the subcortical white matter, both wedge-shaped areas and curvilinear bands of hyperintensity were depicted; the latter extended from the ventricle through the cerebrum towards the cortex and represent dysplastic white matter. Multiple subependimal nodules were visible in both lateral ventricles near the foramen of Monro. CT scan revealed calcifications of some nodules and white matter lesions. No cortical tuber was clearly detectable.
 
 
 
 
 
 
 
 
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