PROTON (H-1) MR SPECTROSCOPY FOR ROUTINE DIAGNOSTIC EVALUATION OF BRAIN-LESIONS

Purpose: To describe the introduction and performance of proton MR spe ctroscopy (H-1-MRS) in the daily routine of a modem standard MR unit. Material and Methods: Over an 8-month period, 52 patients with brain l esions were studied with H-1-MRS, using SE and STEAM sequences for che mical-shift imaging and single-volume spectroscopy. The quality of the spectra was graded from 1 (best) to 3, and the main factors influenci ng the quality of the spectra were evaluated. Results: Of the measurem ents: 85% were graded as 1; 12% as 2; and 3% as 3. The main reasons fo r poor spectral quality were: the unfortunate positioning of the VOI; hemorrhage; and/or postoperative changes within the VOI. Of 40 patient s with a final diagnosis: MRS provided an increased confidence in MR d iagnosis in 18 cases; MRS contributed significantly to preoperative di agnosis in 3 cases; and the spectra were not specific (n=10) or were d ifficult to evaluate (n=9) owing to reduced quality (grade 2 or 3) in 19 cases. Conclusion: MRS of the brain can provide a high percentage o f interpretable spectra and frequently can increase confidence in the MR diagnosis of brain lesions in clinical routine.