MR Spectroscopy evaluation of white matter signal abnormalities of different non-neoplastic brain lesions

Our aim was to evaluate the efficacy of MR Spectroscopy in characterization of white matter signal abnormalities diagnosed by MRI detect changes in different metabolites and peaks of inflammation. 93 patients (49 females and 44 males) age ranging from 2 to 63 years with average (37 ± 2.34 years) presented with white matter hyperintense lesions on T2 and T2 FLAIR and/or contrast enhanced T1WI diagnosed on MRI are included our study. In Infectious group: Average Cho/NAA ratio: 0.79 ± 0.19, Cho/Cr ratio: 0.95 ± 0.17, NAA/Cr 1.89 ± 0.69, in inflammatory group Cho/NAA ratio: 0.65 ± 0.15, Cho/Cr ratio: 0.98 ± 0.29, Average NAA/Cr ratio 1.69 ± 0.19. In ischemic group: Average Cho/NAA ratio: 0.83 ± 0.09, Cho/Cr ratio: 0.81 ± 0.23, Average NAA/Cr 1.54 ± 0.39, in metabolic group: Average Cho/NAA ratio: 0.57 ± 0.13, Cho/Cr ratio: 0.76 ± 0.26; NAA/Cr ratio was 1.73 ± 0.44, in mitochondrial group, Average Cho/NAA ratio: 0.62 ± 0.19, Cho/Cr ratio: 0.54 ± 0.14, NAA/Cr ratio was 1.49 ± 0.59, in inherited dysmyelinating; Cho/NAA ratio: 0.51 ± 0.17, Cho/Cr ratio: 0.63 ± 0.13; Average NAA/Cr ratio was 1.87 ± 0.65. Glutamate and myoinositol peak raised in inflammatory, infectious, metabolic, inherited, and ischemic group mainly in the acute and subacute stage. Amino acids and succinate peak specifically are raised in brain abscesses. MRS is a noninvasive additional MRI technique to define the nature of non-neoplastic brain lesions. Together with image analysis, it may be the key to etiologic diagnosis or, at least, definition of the group where the lesion is classified, by detecting changes in different metabolites and peaks of inflammation.