title: Lhermitte-Duclos disease: MR diffusion and spectroscopy.
abstract: OBJECTIVE
  To describe two cases of Lhermitte-Duclos disease studied with Diffusion MRI and MRi Spectroscopy.
  
  
  METHODS
  Two patients showing a space-occupying lesion in the cerebellar hemisphere were studied by conventional MRI associated with Diffusion MRI and Spectroscopy.
  
  
  RESULTS
  Conventional MRI showed the typical morphological pattern of Lhermitte-Duclos disease with a slow-growing cerebellar mass mainly involving the cortex and non-enhancing thickened cerebellar folia. The mass exerted mild compression of the IV ventricle causing hydrocephalus On Diffusion imaging showed the lesion to be hyperintense due to residual T2-activity and hypointense on the ADC map. Spectroscopy was typical with an increased lactate peak and a reduced choline peak, indicating abnormal anaerobic glycolysis and demyelination, respectively.
  
  
  CONCLUSIONS
  Lhermitte-Duclos disease is a neurological condition which presents several signs and symptoms related to the cerebellar mass. Cowden's syndrome, an autosomal dominant neoplastic disorder with malignant features is associated in 40% of cases. MRI associated with functional examinations such as Diffusion Imaging and Spectroscopy is the imaging modality of choice in LDD patients. They allow a definite diagnosis as the neuroradiological findings correlate well with molecular biology theories regarding the malformative nature of dysplastic cerebellar gangliocytoma.
authors.affiliation: U.O. Neuroradiologia, Cattedra di Neuroradiologia, Azienda Ospedaliera Policlinico Consorziale, Università degli Studi di Bari, Bari, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gaballo
authors.forename: Michele
authors.initials: M
authors.lastname: Palma
authors.forename: Franca
authors.initials: F
authors.lastname: Dicuonzo
authors.forename: Aristide
authors.initials: A
authors.lastname: Carella
mesh_terms: D000368:Aged; D002528:Cerebellar Neoplasms / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging; D005729:Ganglioneuroma / Q000175:diagnosis*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged