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ORIGINAL ARTICLE
Year : 2016  |  Volume : 44  |  Issue : 1  |  Page : 23-32

Intracranial space occupying lesions: could differentiation be reached without biopsy?


1 Department of Radiodiagnosis and Medical Imaging, Faculty of Medicine, Tanta University, Tanta, Egypt
2 Department of Neurosurgery, Faculty of Medicine, Tanta University, Tanta, Egypt
3 Department of Radiodiagnosis and Medical Imaging, Basyion General Hospital, Egypt

Correspondence Address:
Reda A Al-Arabawy
Department of Radiodiagnosis and Medical Imaging, Faculty of Medicine, Tanta University, Tanta
Egypt
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DOI: 10.4103/1110-1415.180554

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Hypothesis Definite diagnosis and characterization of intracranial mass lesions based on structural MRI alone may be difficult. In such cases, proton magnetic resonance spectroscopy (MRS) represents an advance in the specificity of brain lesion diagnosis. Aim of the work The aim of this study was to evaluate the role of MRS in the differentiation of intracranial space occupying lesions (benign/malignant) and malignant (low-high grade)/metastasis. Patients and methods The study was conducted on 40 patients with intracranial space occupying lesions. All patients were subjected to MRS The ratios were calculated, including Cho/NAA and Cho/Cr, in both intralesional and perilesional regions. Results MRI and MRS of the patients were compared with histopathological analysis and we found the following results: conventional MRI had successfully diagnosed 27 cases as primary tumors and three cases as metastasis. Conventional MRI had failed to take decision in six cases as to whether they were primary or metastatic and four cases were diagnosed as non-neoplastic lesions. MRS had correctly diagnosed 31 cases as primary tumors of the 40 cases; five cases were diagnosed as metastasis and four cases were diagnosed as non-neoplastic lesions. Conclusion MRS provides information on the metabolic state of brain tissue. Thus, it is useful to arrive at a more definitive diagnosis compared with MRI in doubtful intracranial space occupying lesions with similar morphological imaging patterns.


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