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MRI and clinical differences between optic pathway tumours in children with and without neurofibromatosis

J-F Chateil, MD, PhD 1 C Soussotte, MD 1 J-M Pédespan, MD 2 M Brun, MD 1 C Le Manh, MD 1 and F Diard, MD 1

1 Service de Radiologie A 2 Pédiatrie, Hôpital Pellegrin, Place A Raba Léon, 33076 Bordeaux, Cedex, France



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  		Figure 1. 3-year-old boy with neurofibromatosis type 1. Axial T1 weighted image demonstrates a lesion of the left optic nerve, slight dilatation of the subarachnoid space surrounding the origin of the right optic nerve, and asymmetry in diameter between the intracranial portion of the right and the left optic nerves.

 


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  		Figure 2. 7-year-old boy with neurofibromatosis type 1. Axial T1 weighted image after contrast infusion. Enlargement of the intracranial portion of the left optic nerve, moderately enhanced by contrast.

 


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  		Figure 3. 3-year-old boy without neurofibromatosis type 1. Sagittal T1 weighted image after contrast infusion. Large tumour of the chiasma, with a cystic component and a solid portion, strongly enhanced by contrast medium. Medial herniation of the posterior part of the right dilated lateral ventrical, with compression of the aqueduct of Sylvius.

 


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  		Figure 4. 3.5-year-old girl with neurofibromatosis type 1. (a) Coronal T1 weighted image shows enlargement of the right portion of the chiasma. (b) 4 years later, coronal T1 weighted image demonstrates progression in the size of the lesion. The patient remains asymptomatic.

 


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  		Figure 5. 2-year-old boy with neurofibromatosis type 1. (a) Axial T1 weighted image. Normal appearance to the intracranial optic nerves and chiasma. Enlargement of the right intraorbital optic nerve. (b) Axial CT after contrast infusion, 18 months later, demonstrates a large solid tumour of the chiasma; the left cystic component could either be tumour or an entrapment arachnoidal cyst.

 




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