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In Vivo Proton Spectroscopy of Intracranial Infections and Neoplasms
Authors:Nelson T Yamagata  Bruce L Miller  Duncan McBride  Linda Chang  Francis Chiang  Diana Nikas  Diane Osborne  Steven D Buchthal
Abstract:The chemical characteristics of 10 neoplastic and 11 infectious brain masses were studied by in vivo 1H magnetic resonance spectroscopy. In tumors, peak height ratios of n-acetyl-L-aspartate to choline were decreased compared to those in normal brain tissue and infectious masses (p < 0.02), but the ratios in normal brains and those with infections did not differ. N-acetyl-L-aspartate—to-creatine/phosphocreatine ratios were significantly lower in infectious masses and tumors compared to normal brain tissue (p = 0.003). However, in progressive multifocal leukoencephalopathy, N-acetyl-L-aspartate appeared relatively unchanged. Lactate was greater than choline in 9 of 11 brains with infection, 0 of 14 control brains, and 1 of 10 tumors. Lactate-to-choline ratios were significantly elevated in infectious masses compared with tumors (p < 0.01). 1H magnetic resonance spectroscopy is promising for the noninvasive diagnosis of focal brain masses.
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