Role of proton MR spectroscopy in evaluation of intracranial space occupying lesions
Journal Title: MedPulse -International Medical Journal - Year 2017, Vol 4, Issue 12
Abstract
Background: The term “Intra-cranial space occupying lesion” is defined as any neoplasm, benign or malignant, primary or secondary, as well as any inflammatory or parasitic mass lying within the cranial cavity. It is important to distinguish tumours from nonneoplastic mimics as the appropriate treatment is very different in each pathology. Aims and Objective:To evaluate the role of proton MR spectroscopy in evaluation of intracranial space occupying lesions. present study total 30 patients who presented with complaints and examination findings suggestive of intracranial space occupying lesion (SOL) and underwent MR brain with proton MR spectroscopy in the study institute between the study duration were selected. After receiving the informed consent and relevant history the scans were performed with BRIVO MR355 1.5 tesla magnetic resonance system, GE Healthcare. Results: Majority of the patients were more than 40 years of age. 53.33% of patients were male. Majority of the patients were suffering from Glioblastoma Multiforme and metastasis (26.67% patients each) followed by Tuberculoma and Meningioma (16.67% each). In the present study 3 tuberculomas showed decrease in the NAA / Creatine ratio (60%) and 4 cases showed decrease in NAA / choline ratio (in 80% cases). The choline/Creatine ratio was greater than 1 in all cases tuberculomas (100%). Tuberculomas had a high peak of lipids, more choline, and less N-acetyl aspartate and creatinine (in 80 % of cases). The lioblastomas showed raised choline levels as compared to NAA with high choline / NAA ratio, increased choline / creatine ratio. Out of 8 cases of GBM 6 cases showed lipid and / or lactate peaks suggestive of areas of necrosis and / or anaerobic glycolysis. Conclusion: Thus we conclude that proton MR Spectroscopy is an important adjunct to anatomical imaging for evaluation of tumour type and tumour grade. The MR spectroscopy features which favored high grade tumours are high choline levels, highly raised choline / NAA.
Authors and Affiliations
Vikas R Lonikar, Chetan S Ravi, Vivek A Chaudhary
Keywords
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