Differentiation of Solitary Mass Lesion of Brain using MR Spectroscopy with Histopathological Correlation

Different types of solitary brain lesions and also tumefactive demyelinating lesions exhibit many features on CT and MRI that are characteristics of malignancy and surgical biopsy is often performed in suspected tumour. Proton MR Spectroscopy has been used to differentiate different type of these solitary brain lesions. Our purpose is to determine whether MR spectroscopy is able to improve preoperative diagnostic accuracy in case of intracranial solitary tumors. This cross sectional study was carried out among 44 patients who were referred to Radiology and Imaging Department by Neurosurgery and Neuro-medicine department of BSMMU, Dhaka, Bangladesh as MRI suspected glioma for MRS scan during the period of 24 months. MRS was performed in 44 patients with suspected glioma. Metabolic ratio of choline: Cr, NAA: Cr, Lactate: Cr was calculated in short and intermediated echo times (TES). Tumors were subdivided into neoplasm and inflammatory mass. Neoplasm was again subdivided into glioblastoma multiforme and solitary metastasis. The patients were followed up and surgical resection biopsy reports were collected. MRS findings and histopathological findings were then correlated. In this study 68.18% of patients were diagnosed as Glioblastoma multiform by MRS and also in histopathology 18.18%. Patient was diagnosed as solitary metastasis in MRS and 20.45%. Patient was diagnosed as solitary metastasis by histopathology and 13.64%. Patient was diagnosed as abscess in MRS while in histopathology 11.37% patients were diagnosed as abscess.