Cerebral proton magnetic resonance spectroscopic imaging in a neonate with tuberous sclerosis

On the basis of detection of cardiac tumours and an intracerebral subependymal mass, the diagnosis of tuberous sclerosis was made in a fullterm neonate. To evaluate cerebral metabolism cerebral mass proton magnetic resonance spectroscopic imaging (1H-MRSI) was performed. A local decrease in N-acetyl-aspartate (NAA), and an increase in choline signals were found. Lactate could neither be demonstrated in the subependynal nodule, nor in the surrounding tissue, thereby rendering the possibility of a high-grade malignant tumour less likely. No major changes were found at 3 and 6 months of age. The present study demonstrates, that 1H-MRSI may be helpful in metabolic evaluation of cerebral masses in patients with tuberous sclerosis.