Proton MR spectroscopy features of normal appearing white matter in neurofibromatosis type 1.
To determine whether differences exist between neurofibromatosis type 1 (NF1) patients with or without focal lesions and healthy normal volunteers in the metabolite ratios of normal appearing white matter, 27 patients with NF1 (with parenchymal lesion, MR positive, n: 17; without parenchymal lesions, MR negative, n: 10) and 20 healthy volunteers underwent MRI and short TE (31 ms) proton MR spectroscopy (MRS). In 17 patients with parenchymal lesions, 61 focal lesions were detected by MRI. MRS was performed from normal appearing frontal and posterior parietal white matter (FWM and PWM) in NF1 and from control groups. NAA/Cr, Cho/Cr and MI/Cr ratios were calculated. Significant increase in Cho/Cr and MI/Cr ratios were found in FWM and PWM in MR negative and positive groups when compared to control group. NAA/Cr ratio in MR positive group was significantly decreased in FWM compared to control group. There were no significant differences between FWM and PWM in all metabolite ratios of MR negative group. MI/Cr ratio in MR positive group was significantly elevated in PWM compared to FWM. Metabolite changes detected by MRS could indicate demyelination and gliosis in normal appearing white matter in all NF1 patients, and additionally neuroaxonal damage in the FWM of NF1 patients with focal lesions. For that reason, in the clinical evaluation and follow-up of these patients MRS features of normal appearing white matter should be considered in addition to focal lesions.
Alkan
Alpay
A
Department of Radiology, Inonu University School of Medicine, Malatya, Turkey. aalkan@inonu.edu.tr
Sarac
Kaya
K
Kutlu
Ramazan
R
Yakinci
Cengiz
C
Sigirci
Ahmet
A
Aslan
Mehmet
M
Ozcan
Hamdi
H
Yologlu
Saim
S
D000293:Adolescent; D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D002794:Choline / Q000378:metabolism; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D007294:Inositol / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009456:Neurofibromatosis 1 / Q000378:metabolism*; D011446:Prospective Studies; D011522:Protons
D011522:Protons; D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003404:Creatinine; D002794:Choline