title: Differentiation of intracranial tuberculomas and high grade gliomas using proton MR spectroscopy and diffusion MR imaging.
abstract: OBJECTIVE
  The purpose of this study was to determine whether proton MR spectroscopy ((1)H MRS) and diffusion-weighted (DW) imaging can be used to differentiate intracranial tuberculomas from high grade gliomas (HGGs).
  
  
  METHODS
  A total of 41 patients (19 with intracranial tuberculomas and 22 with HGGs) were examined in our study. (1)H MRS and DW imaging were performed at a 1.5T MR scanner before operation or treatment. Concentrations of N-acetylaspartate (NAA), creatine (Cr), choline (Cho), and lipid and lactate (LL) in the contrast-enhancing rim of each lesion were expressed as metabolite ratios and were normalized to the contralateral hemisphere. The apparent diffusion coefficient (ADC) was also calculated. The metabolite ratios and ADC values in the enhancing rim of intracranial tuberculomas and HGGs were compared using the Wilcoxon rank sum test. Diagnostic accuracy was compared using receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  Significant differences were found in the maximum Cho/Cr (P=0.015), Cho/NAA (P=0.001) and Cho/Cho-n ratios (P=0.002), and minimum ADC value (P<0.001) between the intracranial tuberculomas and HGGs. Diagnostic accuracy was higher by minimum ADC value than maximum Cho/Cr, Cho/NAA and Cho/Cho-n ratios (93.8% versus 75.7%, 80.8% and 78.1%).
  
  
  CONCLUSIONS
  These results suggest a promising role for (1)H MRS and DW imaging in the differentiation between the intracranial tuberculomas and HGGs.
authors: Department of Radiology, the First Affiliated Hospital, Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China. pengjuan1209@126.com
authors: Juan
authors: J
authors: Peng
authors: Yu
authors: Y
authors: Ouyang
authors: Wei-Dong
authors: WD
authors: Fang
authors: Tian-You
authors: TY
authors: Luo
authors: Yong-Mei
authors: YM
authors: Li
authors: Fa-Jin
authors: FJ
authors: Lv
authors: Zhi-Wei
authors: ZW
authors: Zhang
authors: Xin-You
authors: XY
authors: Li
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005910:Glioma / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D057054:Molecular Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016862:Tuberculoma, Intracranial / Q000175:diagnosis* / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor