Differential diagnosis in the intracranial diseases: Proton magnetic resonance spectroscopy study

Objective: To Investigate the value of proton magnetic resonance spectroscopy (¹H-MRS) on diagnosis and differential diagnosis of the intracranial diseases by the MRS results of 52 patients. Methods: 12 patients with benign glioma, 16 patients with malignant glioma, 10 patients with meningioma, 8 patients with virus encephalitis, and 6 patients with cerebral infarction underwent MRS in the lesion region. We measured the area within the spectra of N-acetyl-aspartate (NAA), creatine/phosphocreatine (Cr), choline compounds (Cho), and lactate (Lac). Results: The spectra of meningiomas were characterized by absence of NAA. The spectra of gliomas were characterized by the decrease of NAA and Cr, but the increase of Cho. The ratio of Cho to Cr was 2.25±1.21 in benign gliomas, while the ratio of Cho to Cr was 4.65±2.21 in malignant gliomas. The spectra of virus encephalitis appeared the decrease of NAA and the normality of Cr, with the 1.25±0.21 ratio of Cho/Cr. The apparent Lac wave could be seen in all cerebral infarctions. Conclusion: The value of 1H-MRS plays a significant role in the diagnosis and differential diagnosis of gliomas, meningiomas, virus encephalitis, and cerebral infarctions.