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Child's Nervous System
Published in: Child's Nervous System 3/2007

01-03-2007 | Original Paper

Proton magnetic resonance spectroscopy in childhood brainstem lesions

Authors: L. Porto, E. Hattingen, U. Pilatus, M. Kieslich, B. Yan, D. Schwabe, F. E. Zanella, H. Lanfermann

Published in: Child's Nervous System | Issue 3/2007

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Abstract

Background

Diagnosis of brainstem lesions in children based on magnetic resonance imaging alone is a challenging problem. Magnetic resonance spectroscopy (MRS) is a noninvasive technique for spatial characterization of biochemical markers in tissues and gives information regarding cell membrane proliferation, neuronal damage, and energy metabolism.

Methods

We measured the concentrations of biochemical markers in five children with brainstem lesions and evaluated their potential diagnostic significance. Images and spectra were acquired on a 1.5-T imager. The concentrations of N-acetylaspartate, tetramethylamines (e.g., choline), creatine, phosphocreatine, lactate, and lipids were measured within lesions located at the brainstem using Point-resolved spectroscopy sequences.

Results

Diagnosis based on localized proton spectroscopy included brainstem glioma, brainstem encephalitis, demyelination, dysmyelination secondary to neurofibromatosis type 1 (NF 1), and possible infection or radiation necrosis. In all but one patient, diagnosis was confirmed by biopsy or by clinical follow-up.

Conclusions

This small sample of patients suggests that MRS is important in the differential diagnosis between proliferative and nonproliferative lesions in patients without neurofibromatosis. Unfortunately, in cases of NF 1, MRS can have a rather misdiagnosis role.
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Metadata
Title
Proton magnetic resonance spectroscopy in childhood brainstem lesions
Authors
L. Porto
E. Hattingen
U. Pilatus
M. Kieslich
B. Yan
D. Schwabe
F. E. Zanella
H. Lanfermann
Publication date
01-03-2007
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 3/2007
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-006-0221-5

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