title: Proton MR spectroscopy in patients with pyogenic brain abscess: MR spectroscopic imaging versus single-voxel spectroscopy.
abstract: OBJECTIVE
  Single-voxel spectroscopy (SVS) has been the gold standard technique to diagnose the pyogenic abssess. Two-dimensional magnetic resonance spectroscopic imaging (MRSI) is able to provide spatial distribution of metabolic concentration, and is potentially more suitable for differential diagnosis between abscess and necrotic tumors. Therefore, the purpose of this study was to evaluate the equivalence of MRSI and SVS in the detection of the metabolites in pyogenic brain abscesses.
  
  
  METHODS
  Forty-two patients with pyogenic abscesses were studied by using both SVS and MRSI methods. Two neuroradiologists reviewed the MRS data independently. A κ value was calculated to express inter-reader agreement of the abscesses metabolites, and a correlation coefficient was calculated to show the similarity of two spectra. After consensus judgment of two readers, the binary value of metabolites of pyogenic abscesses (presence or absence) was compared between SVS and MRSI.
  
  
  RESULTS
  The consistency of spectral interpretation of the two readers was very good (κ ranged from 0.95 to 1), and the similarity of two spectra was also very high (cc=0.9±0.05). After consensus judgment of two readers, the sensitivities of MRSI ranged from 91% (acetate) to 100% (amino acids, succinate, lactate, lipid), and the specificities of MRSI were 100% for detecting all metabolites with SVS as reference.
  
  
  CONCLUSIONS
  SVS and MRSI provide similar metabolites in the cavity of pyogenic brain abscess. With additional metabolic information of cavity wall and contralateral normal-appearing brain tissue, MRSI would be a more suitable technique to differentiate abscesses from necrotic tumors.
authors: Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC. gerwuver@gmail.com
authors: Shuo-Hsiu
authors: SH
authors: Hsu
authors: Ming-Chung
authors: MC
authors: Chou
authors: Cheng-Wen
authors: CW
authors: Ko
authors: Shu-Shong
authors: SS
authors: Hsu
authors: Huey-Shyan
authors: HS
authors: Lin
authors: Jui-Hsun
authors: JH
authors: Fu
authors: Po-Chin
authors: PC
authors: Wang
authors: Huay-Ben
authors: HB
authors: Pan
authors: Ping-Hong
authors: PH
authors: Lai
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis*; D001922:Brain Abscess / Q000175:diagnosis* / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011522:Protons; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; D011522:Protons