Radial bands sign (tuberous sclerosis)

Changed by Yuranga Weerakkody, 5 May 2019

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The radial bands sign refers to linear bands seen on MRI, radiating from the periventricular white matter to the subcortical region, thought to be specific for tuberous sclerosis ^1,2.

Pathology

The exact pathogenesis of radial bands is uncertain, but they are thought to relate to dysfunction of, or injury to, the radial glial fibres (which go on to transform into astrocytes) and form the scaffolding over which neurons migrate from the periventricular germinal matrix to the cortex ^2,3.

Radiographic features

MRI

These radial bands appear as linear regions of signal abnormality extending from the ventricle to the cortex, slightly fanning out as they reach the periphery.

Signal characteristics in adults are ^1,2:

T1: iso to hypointense
T2 / FLAIR: hyperintense
T1 C+: occasional enhancement is encountered

In young patients with incomplete myelination, signal characteristic are ²:

T1: hyperintense to unmyelinated white matter
T2: iso to hypointense

Differential diagnosis

The main differential is with the transmantle sign of type II focal cortical dysplasia.

~~-<li>T1: hyperintense to unmyelinated white matter</li>~~
~~-<li>T2: iso to hypointense</li>~~
+<li>
+<strong>T1:</strong> hyperintense to unmyelinated white matter</li>
+<li>
+<strong>T2:</strong> iso to hypointense</li>

Images Changes:

Image 4 MRI (FLAIR) ( create )

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