Abstract
Intraaxial neoplasms constitute a major chunk of intracranial neoplasms. As conventional imaging characteristics are sometimes similar especially when grade of tumor is taken into account, Magnetic Resonance Spectroscopy (MRS) helps in differentiating various neoplasms and their grades. Gliomas are the most commonly encountered neoplasms. Due to delay in diagnosis and/or magnitude of symptoms, usually grade IV gliomas are more prevalent. MRS helps to determine the extent of perilesional spread as well.
A total of 44 patients diagnosed with intraaxial brain neoplasms in conventional MRI were subjected to MRS. Study was done over a period of 2 years. Most common age group of presentation was 51-60yrs of age. Grade IV neoplasms were more frequently encountered.
Diagnostic accuracy of MRS with respect to grading of neoplasms reached 88% as compared to 58% in conventional MRI when 1st differential diagnosis was taken into account.
Keywords: Grade IV glioma, Cho/Cr, Cho/NAA, Lipid lactate, MI/Cr.
References
- Riyadh N. Al-Okaili, Jaroslaw Krejza, John H. Woo, Ronald L. Wolf, et al. Intraaxial Brain Masses: MR Imaging–based Diagnostic Strategy - Initial Experience. Radiology. 2007 ; 243 ( 2 ): 539 – 550.
- Fayed N, Olmos S, Morales H, Modrego PJ. Physical basis of magnetic resonance spectroscopy and its application to central nervous system diseases.Am J Applied Sci2006; 3:1836-45.
- Jennifer Butzen, Prost R, Chetty V, Donahue K, Neppl R, Bowen W et al Discrimination between Neoplastic and Non neoplastic Brain Lesions by Use of Proton MR Spectroscopy: The Limits of Accuracy with a Logistic Regression Model. AJNRAm J Neuroradiol2000 Aug;21(7):1213-9.
- Karnawat Shekhar, Apurva Vohra. Comparison of Various Metabolite Ratios in Intracranial Lesions: A Hospital Based Survey. Int J Med Res Prof Jan 2018;4(1):228-31.
- Ahmed Shokry. MRS of brain tumors: Diagrammatic representations and diagnostic approach. The Egyptian Journal of Radiology and Nuclear Medicine. Dec 2012;43(4): 603-6.
- JH Kim, KH Chang, DG Na, IC Song, BJ Kwon, MH Han and K Kim. 3T 1H-MR Spectroscopy in Grading of Cerebral Gliomas: Comparison of Short and Intermediate Echo Time Sequences. American Journal of Neuroradiology. Aug 2006; 27 (7) 1412-8.
- Castillo M, Smith JK, Kwock L. Correlation of myo- inositol levels and grading of cerebral astrocytomas. AJNR Am J Neuroradiol 2000; 21:1645-9.
- Peter E. Ricci, Alan Pitt, Paul J. Keller, Stephen W. Coons, Joseph E. Heiserman Effect of Voxel Position on Single-Voxel MR Spectroscopy Findings. American Journal of Neuroradiology. Feb 2000, 21 (2) 367-74.
Corresponding Author
Dr Braja Behari Panda
Department of Radiodiagnosis, VIMSAR, Burla, India