Magnetic Resonance Spectroscopy versus Histopathology in Diagnosis of Intracranial Lesions

Document Type : Original Article

Authors

1 Department of Neurosurgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt

2 Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: Intracranial lesions are a serious health issue that worsens yearly. it may be difficult or even impossible to distinguish between various tumors by MRI which is made by histopathology. The ability to identify various brain metabolites is provided by magnetic resonance spectroscopy [MRS], a non-invasive imaging tool used to evaluate brain pathologies.
Aim of the work: To compare between magnetic resonance spectroscopy [MRS] and histopathology in diagnosis of intracranial lesions.
Patients and Methods: This research is a retrospective trial including [20] patients with intracranial lesions who have done magnetic resonance spectroscopy preoperatively and operated by open surgery.
Results: Our study revealed that the mean age was 39.3 ± 20.3 years. As regards symptoms there was headache in 10 patients [50%], vomiting in 5 patients [25%], fits in 2 patients [10%], weakness in 3 patients [15%], anosmia in 1 patient [5%], visual disturbances in 3 patients [15%] and behavioral changes in 2 patients [10%]. Histopathology confirmed the following MRS finding; 3 high-grade gliomas [15 %], 5 crainopharyngioma [25 %], one central neurocytoma [5 %], 6 meningioma [30 %], 2 brain Abscesses [10 %] and 1 inflammation [5 %]. There was a statistically substantial variation between final results of MRS and histopathology [P value = 0.009]. The sensitivity, specificity of the MRI to diagnose brain tumor was found to be 88.2%, 100 respectively. As regard the tumor markers, the median and IQR CHO / NAA ratio and CHO/Cr ratio was 2.3 [1.8 - 2.8], and 1.7 [1.6 - 3] respectively.
Conclusion: MRS accurately identifies various lesions depending on the metabolic spectrum and ratios as well as distinguishing neoplastic and non-neoplastic brain lesions. It might be used for grading tumors, guiding stereotactic biopsy, and monitoring postoperative patient.

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