title: Proton (1H) MR spectroscopy for routine diagnostic evaluation of brain lesions.
abstract: OBJECTIVE
  To describe the introduction and performance of proton MR spectroscopy (1H-MRS) in the daily routine of a modern standard MR unit.
  
  
  METHODS
  Over an 8-month period, 52 patients with brain lesions were studied with 1H-MRS, using SE and STEAM sequences for chemical-shift imaging and single-volume spectroscopy. The quality of the spectra was graded from 1 (best) to 3, and the main factors influencing the quality of the spectra were evaluated.
  
  
  RESULTS
  Of the measurements: 85% were graded as 1; 12% as 2; and 3% as 3. The main reasons for poor spectral quality were: the unfortunate positioning of the VOI; hemorrhage; and/or postoperative changes within the VOI. Of 40 patients with a final diagnosis: MRS provided an increased confidence in MR diagnosis in 18 cases; MRS contributed significantly to preoperative diagnosis in 3 cases; and the spectra were not specific (n = 10) or were difficult to evaluate (n = 9) owing to reduced quality (grade 2 or 3) in 19 cases.
  
  
  CONCLUSIONS
  MRS of the brain can provide a high percentage of interpretable spectra and frequently can increase confidence in the MR diagnosis of brain lesions in clinical routine.
authors.affiliation: Department of Diagnostic Radiology, University Hospital, Lund, Sweden.
authors.forename: I M
authors.initials: IM
authors.lastname: Burtscher
authors.forename: F
authors.initials: F
authors.lastname: Ståhlberg
authors.forename: S
authors.initials: S
authors.lastname: Holtås
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000032:analysis; D001927:Brain Diseases / Q000175:diagnosis* / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D002543:Cerebral Hemorrhage / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D002794:Choline / Q000032:analysis; D003401:Creatine / Q000032:analysis; D003937:Diagnosis, Differential; D004814:Epidermal Cyst / Q000175:diagnosis; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D006859:Hydrogen; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology; D011300:Preoperative Care; D011522:Protons; D012680:Sensitivity and Specificity
chemical_list: D011522:Protons; D001224:Aspartic Acid; D006859:Hydrogen; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline