A Radiological Role of Proton Magnetic Resonance Spectroscopy in Characterization of Neoplastic and Non Neoplastic Intracranial Lesions
European Journal of Molecular & Clinical Medicine,
2021, Volume 8, Issue 4, Pages 890-903
AbstractThe term “Intra-cranial space occupying lesion” (ICSOL) is used to represent any neoplasm, benign or malignant, primary or secondary, as well as any inflammatory or infectious mass lying within the cranial cavity. It also includes haematomas, different types of cysts, and vascular malformations Magnetic resonance spectroscopy is a simple, easily available, non-invasive, cost effective and easily reproducible investigation modality for intracranial pathologies. After undergoing this study, prompt and accurate diagnosis may help in better management.
Materials and Methods: The present study was conducted at Department of Radio-diagnosis, Basaveshwara Teaching and General hospital attached to M. R. Medical college, Kalaburagi. The study design was a one and half year observational study. The present study was conducted from December 2014 to June 2016.
Result: We found the predominant cause of intracranial space occupying lesions to be neoplasms (64%). Of the neoplastic lesions 65% were intra-axial and 35% were extra axial. Gliomas (14 cases) were the most prevalent intra-axial neoplasms and meningiomas (6 cases) the most prevalent extra-axial neoplasms. Infections comprised 30% of all cases most of which were tuberculomas. The rest 6% of cases were formed by tumefactive demyelinating lesions of multiple sclerosis. Irrespective of cause, the predominant presenting symptoms were headache and neurological deficits, seen in 22 patients each, followed by seizures (20 patients). Even in infections, whether tuberculomas or abscesses, many of the patients did not present with fever or meningismus making the diagnosis difficult clinically.
Conclusion: Magnetic resonance spectroscopy is a newer non invasive modality which provides biochemical information about different tissues that cannot be obtained by conventional MRI alone even after contrast administration. It complements MRI and is particularly useful when the MRI findings are inconclusive. It characterizes lesions based on metabolite patterns and ratios. Choline, N-acetyl aspartate, creatine, lactate, lipids, alanine, amino acids and myoinositol are the major metabolites studied.
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