Tuberous sclerosis complex (TSC) imaging surveillance
Recommended: MRI Brain (cortical tubers, SEGA surveillance) + MRI/US Abdomen (renal AMLs) is the preferred imaging study for tuberous sclerosis complex (tsc) imaging surveillance. Multi-organ surveillance per TSC consensus.
Recommended study
MRI Brain (cortical tubers, SEGA surveillance) + MRI/US Abdomen (renal AMLs)
Multi-organ surveillance per TSC consensus. Brain MRI every 1-3 years; abdomen MRI every 1-3 years.
If the default doesn't apply
Cardiac rhabdomyoma in infant
US
Echocardiogram
No contrast
LAM (women) screening
CT
HRCT Chest at age 18
No contrast
Watch-outs
SEGA growth → hydrocephalus
Sub-ependymal giant cell astrocytoma may obstruct foramen of Monro; surveillance + mTOR inhibitors (everolimus) reduce growth.
Renal AML rupture risk
Tumors > 4 cm or with macroaneurysms at risk for bleeding — embolize or treat with mTOR inhibitor.
Pearls
- Classic neuroimaging: cortical-subcortical tubers, subependymal nodules, white matter radial migration lines, SEGAs.
- Renal manifestations: bilateral angiomyolipomas (fat-containing), cysts.
- Cardiac rhabdomyomas regress with age; pulmonary LAM in 30-40% of adult women with TSC.