What is the role of imaging studies in the workup of tuberous sclerosis complex (TSC)?

Updated: Aug 21, 2018
  • Author: David Neal Franz, MD; Chief Editor: Amy Kao, MD  more...
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Answer

Three imaging procedures are usually undertaken: CT or MRI scans of the brain, renal ultrasounds, and echocardiograms. Some centers perform these evaluations annually, at least until adulthood. This is a topic of some controversy, as the natural history of TSC and the cost-effectiveness of these types of screening examinations are not known clearly. Some are concerned that routine screening can lull the clinician into a false sense of security, and thus into ignoring symptoms that arise between serial examinations. Suggested frequency of monitoring tests was documented by the 2012 International Tuberous Sclerosis Complex Consensus Conference. This includes brain MRI every 1–3 years until the age of 25 years; annual clinical assessment of renal function and blood pressure; abdominal MRI (for instance, at the same as brain MRI), CT or ultrasound; echocardiogram every 1–3 years in asymptomatic patients until regression of cardiac rhabdomyomas is documented, and 12-lead ECG every 3–5 years; and high-resolution chest CT every 5–10 years in asymptomatic females 18 years of age and older, and every 2–3 years in patients with lung cysts. [14]


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