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MR spectroscopy in the evaluation of enhancing lesions in the brain in multiple sclerosis
J A Hirsch1, R E Lenkinski, R I Grossman
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
Purpose:
To compare proton MR spectroscopic alterations with the degree of contrast enhancement in multiple sclerosis (MS) lesions.
Methods:
Thirty-five patients with clinically diagnosed MS were studied with MR spectroscopy. A total of 47 lesions were examined. Solvent-suppressed proton spectra were acquired with an echo time of 16 milliseconds using the point-resolved spectroscopic localization method from 1.5 cm3 voxels. Marker peaks/creatine (Cr) ratios obtained from these spectra were plotted against the relative enhancement of the lesion seen after administration of contrast material. The relative enhancement was defined as S(contrast) -S0/S0, where S0 is the signal intensity of a T1-weighted image and S(contrast) is the signal intensity after administration of gadopentetate dimeglumine.
Results:
We found a positive linear relationship between the marker peaks/Cr ratio and the degree of enhancement of the lesion. That is, the marker peaks/Cr ratio was higher in the lesions that showed the greatest enhancement.
Conclusion:
The MR/Cr ratio obtained with the use of short-echo-time proton MR spectroscopy correlates with the degree of contrast enhancement. This ratio may therefore serve as a means for evaluating and quantifying the level of inflammatory activity within the plaques of patients with MS.
Insights
Proton MR spectroscopy reveals a correlation between marker peaks/creatine ratios and contrast enhancement in multiple sclerosis (MS) lesions. This finding may help quantify inflammatory activity in MS plaques.
Area of Science:
- Neuroimaging
- Biochemistry
- Medical Physics
Background:
- Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system.
- Assessing the degree of inflammation in MS lesions is crucial for disease management.
- Contrast enhancement on MRI indicates active inflammation and blood-brain barrier breakdown.
Purpose of the Study:
- To investigate the relationship between proton MR spectroscopic alterations and contrast enhancement in MS lesions.
- To determine if MR spectroscopy can quantify inflammatory activity in MS.
Main Methods:
- Proton MR spectra were acquired from 47 MS lesions in 35 patients using a short echo time (16 ms).
- Marker peaks/creatine (Cr) ratios were calculated from the spectra.
- Lesion enhancement was quantified after gadolinium contrast administration and compared with the MR/Cr ratio.
Main Results:
- A positive linear relationship was observed between the marker peaks/Cr ratio and the degree of lesion enhancement.
- Lesions with greater contrast enhancement exhibited higher marker peaks/Cr ratios.
Conclusions:
- The MR/Cr ratio derived from short-echo-time proton MR spectroscopy correlates with contrast enhancement in MS lesions.
- This ratio shows potential as a quantitative marker for inflammatory activity in MS plaques.