CLINICAL-APPLICATIONS OF PROTON MAGNETIC- RESONANCE SPECTROSCOPY OF THE BRAIN

In spite of all the scientific advances of the past few years, proton magnetic resonance spectroscopy of the brain has not attained the stat us of a routine examination technique with clinically accepted indicat ions. The method should be considered as an additional option to MR im aging for inherited and acquired encephalopathic changes as well as, i n future, for localization diagnosis of epilepsies. A proton magnetic resonance spectroscopic investigation without a prior intensive clinic al and imaging investigation is not useful. Above all, factors influen cing metabolite distribution such as for example, serum osmolality mus t be known. Methodological prerequisites for the clinical application of proton resonance spectroscopy are, first of all, a high stability o f the chosen technique as well as a sufficiently certain quantificatio n of metabolites and the availability of a reference group. The use of short echo times is necessary for the quantification of glutamine and the osmolyte myo-inositol. Indications for individual cases in which clinical investigations and MR topography cannot provide sufficient ce rtainty and spectroscopy can furnish additional information are, in ad dition to uses in neuropediatrics, the suspicion of Alzheimer's dement ia, HIV encephalopathy in early manifestations, and unclarified depres sions of consciousness accompanying liver cirrhosis.