Related Experiment Videos
Comparative evaluation of magnetization transfer MR imaging and in-vivo proton MR spectroscopy in brain tuberculomas
Rakesh K Gupta1, Mazhar Husain, Devendra K Vatsal
1Department of Radiodiagnosis, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow-226014, India. rgupta@sgpgi.ac.in
Abstract:
We have compared and analyzed the value of in vivo proton MR spectroscopy (PMRS) and T1 weighted magnetization transfer (MT) MR imaging in tissue characterization of brain tuberculomas. We studied 33 cases of proven intracranial tuberculomas with in vivo PMRS and T1 weighted MT MR imaging. MT ratios from the rim and core of the tuberculomas were calculated and compared with metabolites seen on PMRS. Final diagnosis of tuberculoma was based on histopathology (n = 26) and/or associated tuberculous meningitis (n = 7) in all the cases. Out of the 33 patients who underwent both PMRS and T1 weighted MT MR imaging, spectroscopy showed only lipids at 0.9 ppm, 1.3 ppm, 2.0 ppm, and 2.80 ppm in 26 cases while lipids at 0.9 ppm, 1.3 ppm, 2.0 ppm and 2.80 ppm along with choline at 3.22 ppm was seen in remaining 7 patients. MT ratios from the core or solid necrosis varied from 21-29% while from the rim or cellular region varied from 16-24%. MT ratios from all the 33 lesions were consistent with tuberculomas while PMRS showed choline along with lipids in 7 predominantly cellular lesions simulating a neoplasm. We conclude that T1 weighted MT MR imaging appears to be more consistent in the tissue characterization of brain tuberculomas.
Insights
Magnetization transfer (MT) MR imaging is more reliable than proton MR spectroscopy (PMRS) for characterizing brain tuberculomas. MT imaging consistently identified tuberculomas, aiding in accurate tissue diagnosis.
Area of Science:
- Neurology
- Radiology
- Biomedical Imaging
Background:
- Brain tuberculomas are challenging to diagnose using conventional imaging.
- Distinguishing tuberculomas from other brain lesions is critical for effective treatment.
Purpose of the Study:
- To compare the diagnostic value of in vivo proton MR spectroscopy (PMRS) and T1-weighted magnetization transfer (MT) MR imaging for brain tuberculoma tissue characterization.
- To assess the consistency of MT ratios and spectroscopic findings in proven tuberculomas.
Main Methods:
- Studied 33 patients with proven intracranial tuberculomas using both PMRS and T1-weighted MT MR imaging.
- Calculated MT ratios from tuberculoma cores and rims.
- Correlated MT ratios with metabolite profiles obtained from PMRS.
Main Results:
- PMRS detected lipids in most cases; 7 lesions showed additional choline, mimicking neoplasms.
- MT ratios from tuberculoma cores ranged from 21-29%, and rims from 16-24%.
- MT imaging provided consistent characterization across all 33 tuberculomas.
Conclusions:
- T1-weighted MT MR imaging demonstrates greater consistency than PMRS in the tissue characterization of brain tuberculomas.
- MT imaging is a valuable tool for differentiating tuberculomas from other intracranial lesions.