Application of Fluid-Attenuated Inversion Recovery pulse sequence in children with tuberous sclerosis

To evaluate the application of Fluid-Attenuated Inversion Recovery (FLAIR) pulse sequence to increase the sensitivity of detecting tubers in tuberous sclerosis patients compared with fast spin-echo T2-weighted (FSET2W) image, we obtained 12 magnetic resonance (MR) images in 10 patients (mean age = 57.7 months old). Among the 12 examinations, 114 cortical and 128 subcortical tubers were revealed on the FLAIR images, whereas 54 and 72 tubers were found respectively on the FSET2W images. This may be due to the FLAIR pulse sequences remarkably attenuated CSF signals in comparison with the FSET2W images. However, FSET2W image delineated more subependymal nodules than FLAIR imaging did. Gd-DTPA enhanced T1W image is the most suitable pulse sequence to detect giant cell astrocytoma near the foramen of Monro. The results in cases of infants and little children were similar.