Necrotic Tumor versus Brain Abscess: Importance of Amino Acids Detected at¹H MR Spectroscopy—Initial Results

Abstract

The detection of amino acid resonance at 0.9 ppm at in vivo 1H MR spectroscopy (136-msec TE) is a promising tool for distinguishing bacterial abscesses and cystic brain tumors.

Brain Abscess and Glioblastoma Identified by Combined Proton Magnetic Resonance Spectroscopy and Diffusion-Weighted Magnetic Resonance Imaging. Two Case Reports.

“…1 H-MRS is useful for the diagnosis of brain abscess. 3,4,7,8) 1 H-MRS shows the presence of Ac, Lac, and AA, the products of bacterial metabolism in patients with brain abscess, 3,7,8) and the absence of normal brain components (NAA, Cho, and Cr). On the other hand, glioblastomas reveal a high Cho peak, the presence of Cr and Lac, and decrease of NAA.…”

“…However, rapid and correct diagnosis is needed because these different entities require different types of treatment. Proton magnetic resonance spectroscopy ( 1 H-MRS) 3,4,7,8) or diffusion-weighted MR imaging (DWI) 1,2,5,6,9) have been used for the diagnosis of cystic lesions, but not in combination. We describe two cases illustrating the use of 1 H-MRS and DWI for the differential diagnosis of brain abscess and necrotic tumor.…”

Development of a decision support system for diagnosis and grading of brain tumours using in vivo magnetic resonance single voxel spectra

“…1 H-MRS spectra of brain tumours and other focal lesions are often quite distinctive and a spectrum can now be acquired within a few minutes during a routine MRI examination on a standard 1.5 T instrument. Radiologists with experience in interpreting spectral data have found that they can significantly increase their accuracy in categorizing brain lesions when MRS is combined with conventional radiology (6)(7)(8)(9)(10)(11). Moreover, computerbased decision support systems for brain tumour diagnosis focusing on multivoxel (MV) data have been previously described (12,13).…”

Neonatal brain infections

“…In late-stage abscesses, DWI is again accurately demonstrating pus [20][21][22]. Magnetic resonance spectroscopy has been used to analyse the central components of abscesses, revealing firstly the absence of normal brain metabolites (N-acetyl aspartate, choline, creatine), and secondly, the presence of residue from anaerobic glycolysis (lactate, lipids, acetate and succinate) and proteolysis (amino acids) [23,24].…”