Korean J Radiol.  2010 Apr;11(2):244-248. 10.3348/kjr.2010.11.2.244.

Assessing a Dysplastic Cerebellar Gangliocytoma (Lhermitte-Duclos Disease) with 7T MR Imaging

Affiliations
  • 1Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany. ch.moenninghoff@uk-essen.de
  • 2Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Germany.
  • 3Department of Neurology, University Hospital Essen, Germany.

Abstract

Lhermitte-Duclos disease (LDD; dysplastic cerebellar gangliocytoma) is a rare hamartomatous lesion of the cerebellar cortex and this was first described in 1920. LDD is considered to be part of the autosomal-dominant phacomatosis and cancer syndrome Cowden disease (CS). We examined the brain of a 46-year-old man, who displayed the manifestations of CS, with 7 Tesla (T) and 1.5T MRI and 1.5T MR spectroscopy (1H-MRS). We discuss the possible benefits of employing ultrahigh-field MRI for making the diagnosis of this rare lesion.

Keyword

Lhermitte-Duclos disease; 7 Tesla; Magnetic resonance (MR); Dysplastic cerebellar gangliocytoma; Susceptibility-weighted imaging

MeSH Terms

Cerebellar Cortex/pathology
Cerebellar Neoplasms/complications/*pathology
Diagnosis, Differential
Gait Ataxia/etiology
Hamartoma Syndrome, Multiple/complications/*pathology
Humans
Image Processing, Computer-Assisted/methods
Magnetic Resonance Imaging/*methods
Magnetic Resonance Spectroscopy/methods
Magnetics
Male
Middle Aged
Vertigo/etiology

Figure

  • Fig. 1 Dysplastic cerebellar gangliocytoma in 46-year-old man. A. 1.5T T2-weighted axial image reveals left cerebellar mass with typical 'tiger striped' pattern of alternating inner hyperintense and outer hypointense layers (black arrows). B. Proton-MR spectroscopy (TE 135 ms) shows inverted lactate peak and reduction in choline (white arrows). C, D. 1.5T susceptibility weighted minimal intensity projection image depicts single veins running deep between thick folia (arrowheads), whereas 7T susceptibility weighted image demonstrates compression of dentate nucleus (open arrow in D) and multiple, draining veins in greater detail. E, F. Due to increased sensitivity for susceptibility effects, 7T T2* weighted image (F) shows more peritumoral veins (white arrows) than corresponding 1.5T T2* image (E).


Reference

1. Lhermitte J, Duclos P. Sur un ganglioneurome diffuse du cortex du cervelet. Bulletin de l' Association francaise pour l' etude du cancer. Paris. 1920. 9:99–107.
2. Padberg GW, Schot JD, Vielvoye GJ, Bots GT, de Beer FC. Lhermitte-Duclos disease and Cowden disease: a single phakomatosis. Ann Neurol. 1991. 29:517–523.
3. Thomas B, Krishnamoorthy T, Radhakrishnan VV, Kesavadas C. Advanced MR imaging in Lhermitte-Duclos disease: moving closer to pathology and pathophysiology. Neuroradiology. 2007. 49:733–738.
4. Klisch J, Juengling F, Spreer J, Koch D, Thiel T, Buchert M, et al. Lhermitte-Duclos disease: assessment with MR imaging, positron emission tomography, single-photon emission CT, and MR spectroscopy. AJNR Am J Neuroradiol. 2001. 22:824–830.
5. Ambler M, Pogacar S, Sidman R. Lhermitte-Duclos disease (granule cell hypertrophy of the cerebellum) pathological analysis of the first familial cases. J Neuropathol Exp Neurol. 1969. 28:622–647.
6. Carter JE, Merren MD, Swann KW. Preoperative diagnosis of Lhermitte-Duclos disease by magnetic resonance imaging. Case report. J Neurosurg. 1989. 70:135–137.
7. Kulkantrakorn K, Awwad EE, Levy B, Selhorst JB, Cole HO, Leake D, et al. MRI in Lhermitte-Duclos disease. Neurology. 1997. 48:725–731.
8. Meltzer CC, Smirniotopoulos JG, Jones RV. The striated cerebellum: an MR imaging sign in Lhermitte-Duclos disease (dysplastic gangliocytoma). Radiology. 1995. 194:699–703.
9. Nagaraja S, Powell T, Griffiths PD, Wilkinson ID. MR imaging and spectroscopy in Lhermitte-Duclos disease. Neuroradiology. 2004. 46:355–358.
10. Wolansky LJ, Malantic GP, Heary R, Maniker AH, Lee HJ, Sharer LR, et al. Preoperative MRI diagnosis of Lhermitte-Duclos disease: case report with associated enlarged vessel and syrinx. Surg Neurol. 1996. 45:470–475.
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