title: Proton magnetic resonance spectroscopy and apparent diffusion coefficient in evaluation of solid brain lesions.
abstract: OBJECTIVE
  Advanced magnetic resonance techniques can provide insight in physiological changes within pathological canges and contribute to better distinquishing between different tumor types and their discrimination from non-neoplastic lesions. The aim of this study was to evaluate the role of proton magnetic resonance spectroscopy (1H-MRS) and apparent diffusion coefficients (ADC) in distinguishing intracranial glial tumors from tumor like nonneoplastic lesions, as well as for differentiating high- from low-grade gliomas.
  
  
  METHODS
  This retrospective study included 47 patients with solid brain lesions (25 nonneoplastic, 14 low-grade and 8 anaplastic glial tumors). In all patients 1H-MRS (at a TE of 135 ms and 30 ms) and diffusion-weighted imaging (DWI) were performed. The choline to creatine (Cho/Cr), choline to N-acetyl aspartate (Cho/NAA), N-acetyl aspartate to creatine (NAA/Cr) and myoinositol to creatine (mIn/Cr) ratios and the apparent diffusion coefficient (ADC) were determined.
  
  
  RESULTS
  The Cho/Cr ratio was significantly higher in glial tumors grade II than in non-neoplastic lesions (p = 0.008) and in glial tumors grade III than in non-neoplastic lesions (p = 0.001). The Cho/NAA ratio was significantly higher in glial tumors grade II than in non-neoplastic lesions (p = 0.037). AADC/ADC between glial tumors grade II and glial tumors grade III showed a statistical significance (p = 0.023).
  
  
  CONCLUSIONS
  Our study showed that 1H-MRS and apparent diffusion coefficients can help in evaluation and differentiation of solid brain lesions.
authors.affiliation: Radiology and Magnetic Resonance Imaging Center, Clinical Center of Serbia, Belgrade, Serbia. drbgaga@gmail.com
authors.forename: Dragana Ristić
authors.initials: DR
authors.lastname: Balos
authors.forename: Svetlana
authors.initials: S
authors.lastname: Gavrilović
authors.forename: Slobodan
authors.initials: S
authors.lastname: Lavrnić
authors.forename: Brankica
authors.initials: B
authors.lastname: Vasić
authors.forename: Marija
authors.initials: M
authors.lastname: Macvanski
authors.forename: Dusan
authors.initials: D
authors.lastname: Damjanović
authors.forename: Tatjana Stosić
authors.initials: TS
authors.lastname: Opinćal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism* / Q000473:pathology; D001932:Brain Neoplasms / Q000378:metabolism* / Q000473:pathology; D002648:Child; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005910:Glioma / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline