INVOLUZIONE SPONTANEA DELLE LESIONI DELLE VIE OTTICHE IN PAZIENTI AFFETTI DA NF-1: VALUTAZIONE SERIATA MEDIANTE RM CON GD-DTPA

The purpose of this study is to evaluate with contrast MRI the evolution of size, signal and enhancement of the optic-pathway lesions (OPLs) in four patients with NF-1. No treatment of the OPLs was carried out in these patients. In all our cases a change in size, signal and enhancement of OPLs was noted with time and in the last control a clear involution of the OPLs and a dramatic decrease or desappearance of enhancement were detected. The spontaneous regression of lesions that are classified as gliomas is of difficult comprehension in patients without any therapy. Like the intraparenchimalfoci of T2-PDW high signal, that are detected in 60% of patients with NF-1, the OPLs may represent a spectrum of desease and not necessarily neoplastic change. The OPLs could be interpretated as dysplastic lesions and the modification of OPLs enhancement and blood-brain-barrier integrity could represent a different degree of activity of the lesions with a conversion from a reproductive phase to a static one. These acquisitions underline the importance of serial MR examinations and suggest that no aggressive therapy should be undertaken.