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Localized proton magnetic resonance spectroscopy of a cerebellar tumor in a two-year-old child
Authors:B. Wilken  G. Helms  H. J. Christen  J. Bhnk  J. Frahm  F. Hanefeld
Affiliation:(1) Department of Pediatrics and Pediatric Neurology, Georg August University, Robert-Koch-Strasse 40, D-37075 Göttingen, Germany;(2) Biomedizinische NMR Forschungs GmbH am Max-Planck Institut für biophysikalische Chemie, Am Fassberg 11, D-37077 Göttingen, Germany;(3) Department of Neurosurgery, Georg August University, Robert-Koch-Strasse 40, D-37075 Göttingen, Germany
Abstract:
Noninvasive localized proton magnetic resonance spectroscopy (MRS) was used for differential diagnosis of a focal brain lesion in a 2.5-year-old girl. The clinical signs were a mild head tilt and neck pain. Magnetic resonance imaging (MRI) revealed a lesion in the right hemisphere of the cerebellum, but its nature remained obscure. In this lesion quantitative determinations of cerebral metabolites by fully relaxed, short-echo-time proton MRS revealed markedly lowered N-acetylaspartate (NAA) and pronounced elevations of choline-containing compounds (Cho) and myo-inositol (Ins), whereas metabolite concentrations in cortical gray matter and white matter were within normal ranges. The metabolite pattern of the lesion indicated loss of vital neuroaxonal tissue (low NAA) and enhanced glial proliferation (high Cho and Ins), which, together with the MRI morphology, suggested a brain tumor. The diagnosis was established by neurosurgical exploration and total extirpation of the tumor. Histology confirmed an astrocytoma (WHO II). After 2 weeks' recovery the child was discharged with no neurological signs.
Keywords:Magnetic resonance imaging  Magnetic resonance spectroscopy  Children  Brain tumor  Astrocytoma
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