Differentiation between neoplastic and nonneoplastic brain masses using intermediate echo time MR Spectroscopy

Öz

Abstract

Aim: The aim of this study was to evaluate the role of intermediate echo time (TE) Proton Magnetic Resonance Spectroscopy (¹ H-MRS)  in the differential diagnosis of neoplastic and nonneoplastic cerebral mass lesions.

Materials and Methods: The research was done at Cukurova University in a 1.5 Tesla whole-body MR system. In point-resolved-single volume-spectroscopy (PRESS) localization method, Probe-P pulse sequence was studied with intermediate TE (TE=144). Of 55 cases whose diagnosis was confirmed with the histopathologically or clinical and radiological follow-up,  MR Spectroscopy findings were discussed.

Results: Twenty cases’ definite diagnosis were neoplastic and thirty-five cases’ were nonneoplastic lesions. For tumor detection in cerebral mass lesions, intermediate TE MRS  was determined 100% sensitive and 91.7% specific.  The positive predictive value was 86.4% and the negative one was 100%. In this study, in the neoplastic-nonneoplastic lesion differential diagnosis, NAA/Cho, NAA/Cr, Cho/Cr, and Cho/NAA ratios were evaluated and the most useful of them were found to be Cho/NAA ratio.

Conclusion: It is concluded that intermediate TE MR Spectroscopy is a reliable imaging technique for the neoplastic-nonneoplastic differential diagnosis of the cerebral mass lesions.

           

Anahtar Kelimeler

• Magnetic Resonance Spectroscopy,brain neoplasms

Serebral Kitlesel Lezyonların Ayırıcı Tanısında Manyetik Rezonans Spektroskopik İnceleme

Öz

            Amaç: Serebral kitlesel lezyonu olan hastaların optimum klinik yönetimi için doğru tanı esastır. Konvansiyonel MR morfolojiyi değerlendiren yüksek rezolüsyonlu bir tekniktir. Ancak kesin tanı vermede yetersiz kaldığı durumlarda doku biyokimyası hakkında bilgi veren MR spektroskopi gibi fonksiyonel tekniklere ihtiyaç ortaya çıkmıştır. Bu çalışmanın amacı serebral lezyonların ayırıcı tanısında MR spektroskopinin rolünü ve neoplastik-nonneoplastik lezyon ayrımında sensitivite, spesifisite ve doğruluğunu değerlendirmektir.
Gereç ve Yöntem: 1,5 Tesla cihazda PRESS lokalizasyon metodunda Probe-P puls sekansı ile orta TE (TE=144) ile çalışıldı. Tanısı patoloji veya klinik-radyolojik takip ile kesinleşmiş 55 olgudan 37’sinde tek ve 18’inde multivoksel inceleme yapıldı. 46 olguda lezyona ve 9 olguda lezyon periferine yönelik inceleme gerçekleştirildi.
Bulgular: Olguların 20’sinde kesin tanı tümöral ve 35’inde nontümöral patoloji idi. MRS serebral lezyonlarda tümörü saptamada % 100 sensitivite, % 91,7 spesifisiteye sahip bulundu. Pozitif prediktif değer % 86,4 ve negatif prediktif değer % 100 idi. Neoplastik-nonneoplastik lezyon ayrımında NAA/Cho, NAA/Cr, Cho/Cr ve Cho/NAA oranlarının değerlendirildiği bu çalışmada en kullanışlı olan Cho/NAA oranı olup Cho/Cr oranı da hassas bulundu.
Sonuç: MR Spektroskopinin serebral lezyonlarda neoplastik-nonneoplastik lezyon ayrımında güvenilir bir yöntem olduğu sonucuna varılmıştır. Elde edilen spektral verilerden tümörü seçmede en hassas olanı Cho/NAA oranı olup kolin artışı tümör lehine önemli bir bulgudur.

Anahtar Kelimeler

• MR spektroskopi,beyin neoplazmları,tanı

Kaynakça

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