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Neuroradiology |
1 From the Magnetic Resonance Imaging Unit (S.G., F.E., J.F.L.B.), INSERM U438, Université Joseph Fourier, the Corresponding Research Laboratory to the Atomic Energy Center (G.P., A.Z., C.S., C. Rubin, M.D., C. Rémy), the Laboratory of Biochemistry (C.B.), and the Department of Neurosurgery (D.H.), Centre Hospitalier et Universitaire de Grenoble, Hôpital Michallon, 38043 Grenoble cedex 09, France. Received June 23, 1998; revision requested August 5; final revision received March 11, 1999; accepted July 1. Supported in part by the Ligue contre le Cancer, the Association pour la Recherche sur le Cancer, the Ministère de la Santé, and the Biomed 2 program. Address reprint requests to S.G. (e-mail: Jean-Francois.LeBas@ujf-grenoble.fr).
PURPOSE: To assess the usefulness of the 0.9-ppm peak from amino acids (––CH3 moieties from valine, leucine, and isoleucine) for the differentiation of brain abscesses and tumors at in vivo hydrogen 1 magnetic resonance (MR) spectroscopy.
MATERIALS AND METHODS: Amino acid concentrations were determined in vitro in 13 purulent samples from brain and nonbrain tissues and in nine aseptic fluids from necrotic brain tumors at two-dimensional (2D) 1H MR spectroscopy and liquid chromatography. Thirty-four patients with cystic intracerebral mass lesions (28 tumors, six abscesses) were examined at 1H MR spectroscopy in vivo.
RESULTS: Amino acids were identified in vitro in both purulent and aseptic samples. Amino acid concentrations measured in the aseptic fluids at both liquid chromatography and 2D MR spectroscopy were far below the detection threshold of in vivo 1H MR spectroscopy. Quantitative results obtained at 2D MR spectroscopy showed no overlap in the ranges of amino acid concentrations in purulent and aseptic samples. In vivo, the proton spectra obtained with a 136-msec echo time (TE) revealed amino acids (inverted peak at 0.9 ppm) in only the abscesses.
CONCLUSION: 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.
Index terms: Brain abscess, 10.201, 10.204, 10.256 • Brain neoplasms, 10.36, 10.38 • Magnetic resonance (MR), spectroscopy, 10.12145
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