Role of in vivo proton magnetic resonance spectroscopy in the diagnosis and management of brain abscesses.
OBJECTIVE
In vivo proton magnetic resonance spectroscopy was performed for 24 patients with pyogenic brain abscesses, to examine the consistency of the spectral patterns and to observe the changes in metabolites with treatment.


METHODS
Localized proton spectra were obtained from 4- to 8-ml volumes in the abscesses, using stimulated echo acquisition mode and spin echo sequences. Twenty-two patients were treated with combined surgical and medical therapy, and two patients were treated conservatively. High-resolution magnetic resonance spectroscopy was performed for 15 samples of abscesses obtained from these patients, to confirm the assignments of resonances seen in vivo. Postaspiration studies were performed for 12 patients treated with combined medical and surgical therapy and 2 patients treated medically.


RESULTS
Lactate and amino acids were seen in spectra for all patients, irrespective of the time of spectroscopy after the onset of combined medical and surgical therapy. Acetate and pyruvate disappeared after 1 week of combined treatment.


CONCLUSIONS
It was concluded that spectral patterns for brain abscesses are consistent and specific and can assist in the noninvasive diagnosis of abscesses. Responses to combined treatment could be monitored by showing the changes in metabolite patterns in serial spectroscopic studies.
Dev
R
R
Department of Neurosurgery, King George Medical College, Lucknow, Uttar Pradesh, India.
Gupta
R K
RK
Poptani
H
H
Roy
R
R
Sharma
S
S
Husain
M
M
D000293:Adolescent; D000328:Adult; D000596:Amino Acids / Q000378:metabolism; D001921:Brain / Q000378:metabolism; D001922:Brain Abscess / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D019344:Lactic Acid / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D019289:Pyruvic Acid / Q000378:metabolism
D000596:Amino Acids; D019344:Lactic Acid; D019289:Pyruvic Acid