The value of 1H-MRS in identification of malignant glioma and solitary brain metastases

Objective To investigate the clinical application value of 1H-MRS in identification of malignant glioma and solitary brain metastases. Methods A retrospective study was performed on 24 cases of malignant glioma and 15 cases of solitary brain metastases confirmed by surgery and pathology. All 39 patients underwent conventional MRI, enhanced MR and 1H-MRS imaging. To detect the changes of N-acetylaspartate (NAA), choline (Cho) and creatine (Cr), and achieved ratio of NAA/Cr, Cho/Cr and Cho/NAA in the tumor parenchyma, tumor margin, edema area and contralateral normal brain parenchyma. The ratio of Cho/NAA, Cho/Cr and NAA/Cr in tumor parenchyma area, tumor edge area, edema area and contralateral normal brain parenchyma were compared and analyzed. Results Comparison between the ratio of 1H-MRS metabolite of malignant glioma and solitary brain metastases, in tumor parenchyma, the ratios of NAA/Cr were (0.96±0.42) and (1.66±1.10); in tumor edge area, the ratios of NAA/Cr were (1.07±0.47) and (1.48±0.40), the ratios of Cho/NAA were (2.21±1.20) and (1.21±0.35); in peritumoral edema region, the ratios of NAA/Cr were (1.24±0.62), (1.68±0.35), the ratios of Cho/Cr were (1.78±0.79), (1.10±0.26), the ratios of Cho/NAA were (1.51±0.58), (0.67±0.17), and all the differences were statistically significant (all P<0.05). Conclusion 1H-MRS imaging technology can make up the limitations of conventional MRI.The ratio of 1H-MRS metabolite in peritumoral edema has a significant clinical value in identification of malignant glioma and solitary brain metastases. Key words: Solitary brain metastases; Malignant glioma; Magnetic resonance imaging; Magnetic resonance spectroscopy