ABNORMAL OCULAR ENHANCEMENT IN STURGE-WEBER SYNDROME - CORRELATION OFOCULAR MR AND CT FINDINGS WITH CLINICAL AND INTRACRANIAL IMAGING FINDINGS

PURPOSE: To estimate the prevalence of abnormal ocular enhancement in children with Sturge-Weber syndrome as detected with MR imaging and CT and to correlate this with the clinical, fundoscopic, and intracrania l imaging findings. METHODS: Fifteen children, 4 years old or younger, with Sturge-Weber syndrome were examined with enhanced CT and MR imag ing. Eleven children had unilateral intracranial involvement and 4 had bilateral involvement, for a total of 19 abnormal hemispheres and rel ated orbits. The presence of ocular enhancement was compared with the fundoscopic findings independently. Ocular enhancement was correlated with the extent of leptomeningeal disease, the severity of the cutaneo us lesion, and the presence of glaucoma by the calculation of likeliho od ratios and 95% confidence limits. RESULTS: Seven of the 15 patients had abnormal ocular enhancement, which was present in 10 (53%) of the eyes associated with the 19 abnormal hemispheres. MR imaging showed c horoidal hemangioma in 7 of 8 patients in whom hemangiomas were shown at fundoscopy. The likelihood of ocular enhancement was increased with the presence of bilateral disease, extensive facial nevi, and glaucom a; there was no significant correlation with the extent of hemispheric involvement. CONCLUSION: Both enhanced MR imaging and CT can show dif fuse choroidal hemangioma in patients with Sturge-Weber syndrome. Howe ver, MR imaging is more sensitive and is recommended to aid in the det ection of abnormalities with preventable late complications.