International Journal of Tropical Medicine
ISSN: Online 1818-779XISSN: Print 1816-3319
Abstract
A wide range of diseases manifest as ring enhancing lesions on neuroimaging. Magnetic Resonance Spectroscopy (MRS) helps in characterizing these lesions and help in differentiating these disease conditions, which have considerable overlapping conventional MR imaging findings. MR spectroscopy works on the principle of identification of metabolites present in the brain tissues, such as Choline, NAA, creatine, lipid, lactate and myoinositol. The aim of this study is to describe the diagnostic significance of the Magnetic Resonance Spectroscopy in characterization of the ring enhancing lesions of brain, when combined with routine MR imaging protocol. This retrospective study was conducted in Sri Manakula Vinayagar Medical College and hospital, Puducherry, which is a multidisciplinary, 900 bedded hospitals with fully equipped Radiology department. The study was conducted during the period of March 2019 to February 2020. The study was done using 1.5 Tesla PHILIPS INTERA whole body MR systems with standard head coil. Magnetic resonance spectroscopy images was performed through single voxel technique. The study population comprised of forty patients. In this study the youngest patient was 8 years old and oldest being 71 years. The highest incidence of ring enhancing brain lesions was found in the sixth decade, accounting for 25% of cases and the least incidence in the eighth decade, accounting for 2.5% of cases. Among various metabolites in MRS of the study population, elevated Choline peak was the most frequent and reduced NAA peak was the least frequent. In this study, all cases of neurocysticercosis were intraparenchymal form. Neurocysticercosis does not have an elevated lipid peak on MR spectroscopy and patients with tuberculoma typically had an elevated lipid peak. Choline/creatine ratio less than 1, differentiates tuberculoma, from the glioma and metastasis. Patients with tubercular abscesses lacks amino acid peaks, a feature that differentiates from pyogenic abscesses. Patients with glioma and metastasis had an elevated Cho/Cr ratio. Presence of increased choline peaks in the region of surrounding edema is seen in the high‐grade glioma, which is absent in metastasis. Inclusion of the MR spectroscopy to routine MRI protocol helps to diagnose the disease conditions of the brain with confidence.
How to cite this article:
A. M. Anand, Harikrishna Namburi and Elamparidhi Padmanaban. Role of Magnetic Resonance Spectroscopy in Evaluation of the Ring Enhancing Lesions of Brain.
DOI: https://doi.org/10.36478/10.59218/makijtm.2023.4.82.86
URL: https://www.makhillpublications.co/view-article/1816-3319/10.59218/makijtm.2023.4.82.86