[The value of the proton magnetic resonance spectroscopy (HMRS) of white matter injury in children treated with chemo- and/or radiotherapy. Preliminary report].
THE AIM of this study was to estimate the value of HMRS in the diagnosis of brain lesions observed in children treated with chemo and radiotherapy and to assess the possibility to differentiate these lesions from neoplasm or recurrent disease.


METHODS
We examined 6 children, aged from 7 to 15 yrs, 3 with brain tumours, 1 with esthesioneuroblastoma treated with chemo and radiotherapy and 2 patients with chemotherapy only, for other neoplasms (leukemia, Wilms tumor). Indications to perform imaging studies were routine for brain tumour patients (no clinical symptoms) and suspicion of disease recurrence in others. MR with 1.5 T scanner and additionally single voxel HMRS in PRESS sequence were performed.


RESULTS
In all cases MRI showed extensive hyperintensive changes in brain tissue with significant mass effect. In 3 cases HMRS was within normal limits, in other 3 cases moderately elevated peak of choline and peak of lactate and lipids were found. In follow up examinations all lesions regressed and all patients are in good clinical condition.


CONCLUSIONS
It could be difficult to differentiate white matter injury from malignancies on MRI. HMRS in case of doubtful findings on MRI in children treated with chemo and radiotherapy, especially in those without symptoms of their disease, is a helpful method.
Jurkiewicz
Elzbieta
E
Zakład Diagnostyki Obrazowej, Instytut Pomnik Centrum Zdrowia Dziecka, al. Dzieci Polskich 20, 04-730 Warszawa, Poland. mondro@wp.pl
Pakuła-Kościesza
Iwona
I
Drogosiewicz
Monika
M
Dembowska-Bagińska
Bozenna
B
Perek
Danuta
D
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000187:drug effects / Q000473:pathology* / Q000528:radiation effects; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D002648:Child; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D018304:Esthesioneuroblastoma, Olfactory / Q000188:drug therapy / Q000532:radiotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007938:Leukemia / Q000188:drug therapy / Q000532:radiotherapy; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009669:Nose Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D011044:Poland; D011522:Protons; D011832:Radiation Injuries / Q000175:diagnosis* / Q000209:etiology; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012680:Sensitivity and Specificity; D013997:Time Factors; D009396:Wilms Tumor / Q000188:drug therapy / Q000532:radiotherapy
D011522:Protons