Article Figures & Data
Figures
- Fig 1.
A T2-weighted FSE axial image of a normal brain.
A, Localized proton spectrum from the VOI (8 cm3) in the white matter of the left frontal region of 16 healthy volunteers, recorded with use of the PRESS sequence at 3T (TR, 2000 ms; TE, 35 ms). (NAA indicates N-acetylaspartate; Cho, choline-containing compounds; Cr, creatine and phosphocreatine; mIns, myo-inositol; Glx, glutamate plus glutamine.)
B, Location of voxel used for localized proton spectra in healthy volunteers. A T2-weighted FSE axial image (TR, 4200 ms; TE, 93 ms; NEX, 2).
- Fig 2.
A glioblastoma in patient 3.
A, Localized proton spectrum of the edema surrounding the large temporofrontal glioblastoma. The NAA/Cr, NAA/Cho, Cho/Cr, and mIns/Cr ratios are in the normal range. The Glx/Cr ratio is increased to 2.2 (normal value, 1.8 ± 0.2). Glc (3.78 and 3.44 ppm), Lac, Lip, Val, Leu, Ile, and Ala are detected.
B, Axial FSE T2-weighted image (TR, 4200 ms; TE, 93 ms; NEX, 2) with the location of the voxel (6.4 cm3) in the edematous tissue.
C, Axial SE T1-weighted image (TR, 560 ms; TE, 18 ms) after administration of contrast agent. At this level, the upper part of the tumor can be seen.
- Fig 3.
A meningioma in patient 12.
A, Localized proton spectrum of the edema surrounding the meningioma. The NAA/Cho, Cho/Cr, and mIns/Cr ratios are in the normal range. NAA/Cr is decreased to 1.4 (normal value, 1.8 ± 0.3), and Glx/Cr is increased to 2.5 (normal value, 1.8 ± 0.2). Glc, Lac, Lip, Val, Leu, and Ile are detected.
B, Axial FSE T2-weighted image (TR, 4200 ms; TE, 93 ms; NEX, 2) with the voxel (8 cm3) location in the edematous tissue.
C, Axial SE T1-weighted image (TR, 560 ms; TE, 18 ms) after administration of contrast agent with strong enhancement of the tumor.
Tables
NAA/Cr NAA/Cho Cho/Cr mIns/Cr Glx/Cr Glioblastomas (pt no.) 1 1.7 1.6 1.1 0.8 1.8 2 0.9† 0.9† 1 0.6 1.6 3 2 2.2 0.9 0.7 2.2† 4 1† 1† 1 0.6 2.1† 5 1.2† 1.4† 0.9 0.7 2.6† 6 1.5 1.7 0.9 0.5 2 7 1.5 1.9 0.8 0.5 2.8† Metastases (pt no.) 8 1.8 1.7 1 0.4 2.8† 9 1.9 2.3 0.8 0.4 3† 10 1.6 1.4† 1.1 0.4 2.7† Meningiomas (pt no.) 11 1.8 1.9 0.9 0.4 3.2† 12 1.9 1.8 1 0.7 3.7† 13 1.4† 1.8 0.8 0.4 2.5† Note:—NAA indicates N-acetylaspartate; Cr, creatine and phosphocreatine; Cho, choline- containing compounds; Glx, glutamate plus glutamine; mIns, myo-inositol.
* Ratios of the main metabolites are detected by PRESS sequences (TR, 2000 ms; TE, 35 ms) in edema surrounding 7 glioblastomas, 3 metastases, and 3 meningiomas. These values were compared with those obtained in the white matter of the left frontal region with use of the same technique in 16 healthy volunteers between 25 and 67 years old (mean age, 40.7 ± 9 years). The normal values are NAA/Cr 1.8 ± 0.3; NAA/Cho 2 ± 0.4; Cho/Cr 0.9 ± 0.2; mIns/Cr 0.6 ± 0.2 and Glx/Cr 1.8 ± 0.2.
† Altered values.
Glc 3.44 ppm* Lac* Lip* Other Metabolites* Glioblastomas (pt no.) 1 ++ + Val, Leu, Ile 2 + + Val, Leu, Ile 3 + ++ + Val, Leu, Ile, Ala 4 + + Val, Leu, Ile 5 ++ + 6 + + + Val, Leu, Ile 7 + Val, Leu, Ile Metastases (pt no.) 8 ++ + Val, Leu, Ile 9 + + Val, Leu, Ile 10 + + Val, Leu, Ile Meningiomas (pt no.) 11 + ++ + Val, Leu, Ile 12 +++ ++ Val, Leu, Ile 13 ++ + + Val, Leu, Ile, Ala Note:—Glc indicates glucose; Lac, lactate; Lip, lipids; Val, valine; Leu, leucine; Ile, isoleucine; and Ala, alanine.
* Peak resonances of Glc, Lac, and Lip detected and arbitrarily assigned to 1 of 3 grades, low (+), medium (++), or high (+++) on the basis of the ratio of the integral of the metabolite peak to the integral of unsuppressed water peak. For Val, Leu, Ile, and Ala, only their presence is indicated.
