title: [Diagnostic value of magnetic resonance spectroscopy and intraoperative magnetic resonance imaging in the treatment of brain abscesses].
abstract: OBJECTIVE
  To evaluate the diagnostic value of magnetic resonance spectroscopy (MRS) and the role of intraoperative magnetic resonance imaging (iMRI) in the treatment of brain abscesses by aspiration and drainage.
  
  
  METHODS
  From November 2009 to June 2013, Forty-one brain abscess patients were evaluated. MRS was employed to acquire the metabolic information and assist in the differential diagnosis of brain abscesses showing lactate cytosolic amino acids (AAs) with/without succinate, acetate, alanine and glycine on MRS. Diffusion-weighted imaging (DWI) was also helpful. Eleven single deep-seated abscesses underwent aspiration and drainage with 1.5 T iMRI and neuronavigation system.
  
  
  RESULTS
  Forty-one brain abscesses were all diagnosed correctly. Ten single deep-seated abscesses underwent aspiration and drainage with 1.5 T iMRI and neuronavigation system successfully with just one puncture. One deep-seated abscess with thick-walled was punctured thrice before achieving success because of aspirated needle sidesliping. All 11 deep-seated abscess cases were cured and were also confirmed by follow-up. None of them suffered from significant complications, such as intracranial bleeding or new neurological deficit.
  
  
  CONCLUSIONS
  MRS may acquire the metabolic information, confirm the presence of AAs with/without succinate, acetate, alanine and glycine and assist in the differential diagnosis of brain abscesses. iMRI system can help detect aspirated needle sidesliping and correct it in time to improve the cure rate, especially for single deep-seated brain abscess with a thick wall.
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Song
authors.affiliation: Email: cxl73@msn.com.
authors.forename: Xiaolei
authors.initials: X
authors.lastname: Chen
authors.forename: Yunlin
authors.initials: Y
authors.lastname: Tang
authors.forename: Boheng
authors.initials: B
authors.lastname: Tang
authors.forename: Ting
authors.initials: T
authors.lastname: Zeng
authors.forename: Zhenghui
authors.initials: Z
authors.lastname: Sun
authors.forename: Xinguang
authors.initials: X
authors.lastname: Yu
authors.forename: Dingbiao
authors.initials: D
authors.lastname: Zhou
mesh_terms: D000328:Adult; D001922:Brain Abscess / Q000473:pathology* / Q000628:therapy; D003937:Diagnosis, Differential; D004322:Drainage; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation