In vivo proton magnetic resonance spectroscopy 1hmrs can substantially improve the noninvasive categorization of human brain tumors, especially for gliomas. It provides greater information concerning tumor activity and characterization of the tumor tissue than is possible with mri techniques alone. Since brain mri is the primary modality for clinical evaluation of glioma patients, the ability to detect 2hg by mrs could provide important diagnostic and prognostic information. Other imaging tests may include computerized tomography ct scan and positron emission tomography pet. Magnetic resonance imaging mri is superior in delineating anatomic and pathologic information and has subsequently been married to the ability of magnetic resonance spectroscopy mrs to provide. This is perhaps a little harsh, however, it is fair to say that mrs. Meanwhile, 16 of all 22 patients were reexamined using magnetic resonance imaging mri within 6 months of surgical resection. The technique of magnetic resonance spectroscopy usually shortened to mr spectroscopy or mrs allows tissue to be interrogated for the presence and concentration of various metabolites. Localized proton mr spectroscopy mrs of the human brain, first reported more than 20 years ago, is a mature methodology that is used clinically in many medical centers worldwide for the evaluation of brain tumors. Results ten adult patients with a histomolecular n 9 or radiological n 1 diagnosis of grade iiiii diffuse glioma were recruited, 40. Differentiation with proton mr spectroscopy article pdf available in radiology 2303. While there have been studies of human brain tumors using heteronuclei such as phosphorus 31 p and sodium 11 na,5,6. Because of the limitations of conventional mri in differentiating high from lowgrade gliomas, advanced multiparametric magnetic resonance techniques have been used in grading of gliomas and they are diffusionweighted imaging dwi, proton mr spectroscopy, and perfusion imaging. Magnetic resonance imaging of gliomas 231 this is probably related with the fact that th ere is an increase in intracellular water in edematous white matter as well as within the tumor.
Grossman and yousem said if you need this to help you, go back to page 1. Potential of mr spectroscopy for assessment of glioma grading. Pdf lowgrade gliomas and focal cortical developmental. Clinical application of mr spectroscopy in identifying. Increased choline and cholinecreatine ratio and decreased naa levels. Mri spectroscopy will reveal not only decreased nacetylaspartate. Mrs mr spectroscopy of the lesion shows a raised choline peak with a depressed nacetyl aspartate peak.
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