Characterization of In-Vivo Proton Magnetic Resonance Spectroscopic Patterns of Intracranial Space-Occupying Lesions: A 1-Year Observational Study
Journal Title: International Journal of Contemporary Medicine surgery and Radiology - Year 2018, Vol 3, Issue 4
Abstract
Introduction: Magnetic resonance (MR) spectroscopy is a new and emerging imaging modality, which offers a detailed biochemical analysis of the tissues thereby giving us a glimpse of in-vivo human brain metabolism. This study was undertaken to assess the role of MR spectroscopy in characterization and diagnosis of intracranial space-occupying lesions (ICSOLs) when used in addition to conventional magnetic resonance imaging (MRI) and to distinguish between neoplastic and nonneoplastic lesions. Material and Methods: This 1-year observational study was conducted at the Department of Radiodiagnosis, KLE’S Hospital, Belgaum. A total of 50 patients with ICSOLs detected by MRI brain (plain/contrast) scans from January 2012 to December 2012 were studied. Results: Majority of the patients were women (56%) and the most common age-group was 31–45 years. Headache and neurological deficits were the most frequent presenting complaints. Out of total cases, 64% of the lesions were neoplastic and 36% of the lesions were non-neoplastic. High choline (Cho)/creatine (Cr) and Cho/N-acetyl aspartic acid (NAA) ratios were found in neoplastic lesions as compared to non-neoplastic lesions. Among the neoplastic lesions, high-grade gliomas had significantly higher Cho/Cr and Cho/NAA ratios as compared to low-grade gliomas. Lactate and lipid resonances were also present in high-grade gliomas. Among the infectious lesions, abscesses had amino acid peaks and high lactate levels; however, they had low Cho/Cr andCho/NAA ratios, which helped to differentiate them from neoplasms. Tuberculomas demonstrated a prominent lipid peak. Conclusion: Information provided by MR spectroscopy complemented the information obtained by MRI and was particularly helpful in distinguishing neoplastic from non-neoplastic lesions.
Authors and Affiliations
Rajendra V. Mali, Aseem Katyal
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