Purpose: To evaluate the clinical significance of MR spectroscopy as a diagnostic modality in patients with intracranial brain tumors and tumor-like conditions.
Methods: Obtained material from 2004-2017 was evaluated and correlated with histopathological diagnosis. Both short echo and long echo single voxel seqences and clinical shift imaging protocols were interpreted.
Results: It was obvious that N-acetyl aspartate (NAA) level was decreased more than 50% in high grade gliomas, except in multicentric glioblastoma where the spectrum obtained in non-enhancing masses was inconlusive. The presence of lactate peak suggested grade IV astrocytoma. Choline (Cho)-only spectrum was evident in non-glial tumors (meningiomas and macroadenoma), however, also in malignant neoplasms, like malignant peripheral nerve sheath tumors. The metastatic lesions showed Cho and lipid peaks increase. The main controversies were noted in high grade oligodendrogliomas where decreased Cho/Cr (creatine) peak was evident in three patients, most likely due to unexplained elevation of creatine concentration. Tumefactive demelinations showed no difference in the spectrum pattern compared to high grade gliomas.
Conclusion: MR spectroscopy is informative diagnostic tool in evaluation of intracranial masses, but caution is needed in interpretation of multicentric foci in glioblastoma and high grade oligodendrogliomas.
