Results Of Magnetic Resonance Spectroscopy Research Articles

Magnetic Resonance Spectroscopy Findings of Intracranial Chondroma and Chondrosarcoma with a Non-skull Base Origin: A Report of Two Cases

Introduction: Intracranial chondroma and chondrosarcoma are very rare tumors that mainly originate from the base of the skull. Advanced neuroimaging studies, including magnetic resonance spectroscopy (MRS), play a pivotal role in both tumor diagnosis and presurgical planning. Case Presentation: We present two cases of intracranial cartilaginous tumors, including a chondroma and a chondrosarcoma, both of which presented with severe headaches. Due to inconclusive conventional MRI and MRS results, they were both primarily diagnosed as intra-axial brain tumors. However, pathological reports later confirmed the diagnosis of a chondroma and a chondrosarcoma. Conclusion: Based on the present findings, the use of advanced neuroimaging techniques, such as MRS, may improve diagnostic accuracy. We believe that MRS can play a significant role in the surgical planning of similar cases. Also, reporting rare cases worldwide can contribute to the improvement of radiographic diagnosis.

Diagnostic Accuracy of Magnetic Resonance Spectroscopy in Differentiating Malignant and Benign Brain Lesions

The aim of this study is to determine the diagnostic ability of magnetic resonance spectroscopy in separating malignant and benign cerebral masses, when histopathology taken as gold standard. The results of my study will not only resolve this controversy but also If MRS diagnostic accuracy will be found high in distinguishing ring enhancing lesions of brain, then this non-invasive modality can be applied routinely in our general practice for proper treatment selection the lesions in order to reduce the morbidity and mortality of these particular patients. Materials & Methods: We included around 141 cases presenting to us at the Radiology department of Sir Ganga Ram Hospital, Lahore, fulfilling the inclusion criteria was selected after we got approval for the study from IRB committee of university. Informed consent was taken from each patient. We performed magnetic resonance spectroscop in each case using 1.5 Tesla MR system having graded power of 33 mT/m and results of MRS were read and reported by one radiology consultant. Malignant or benign lesions were noted on MRS. After this, each patient was undergone biopsy in the concerned ward by the consultant neurosurgeon and tissue was sent to institutional pathology laboratory for histopathology. Histopathology results were interpreted by the consultant histopathologist (at least 3 years of post-fellowship experience) and benign or malignant lesion was noted Results: All the included cases underwent standard magnetic resonance spectroscopy (MRS) of brain. MRS strengthened the suspicion of malignant brain lesions in 94 (66.67%) cases. Histopathology findings confirmed malignant brain lesions in 90 (63.83%) cases. Conclusion: This study concluded that MRS is the non-obstrusive method of imaging with greater diagnostic accuracy in differentiating malignant and benign brain lesions, and that it has not only made drastically better our capability to identify malignant brain lesions preoperatively, and moreover assists neurosurgeons in taking much better decisions. As a result, we urge that MRS be performed habitually in all suspected instances of intracranial mass lesion for reliable pre-operative identification of malignant brain lesions and selection of appropriate surgical technique. Keywords: MRS. MRI. Brain lesions, brain tumor, CNS tumor, Magnetic resonance spectroscopy

Steatosis Grading Comparison Between Qualitative Ultrasonography and Magnetic Resonance Spectroscopy in Patients With Nonalcoholic Fatty Liver Disease

Objective: Assess the correlation between the qualitative sonographic score for detecting hepatic steatosis (HS) and liver fat quantification, using proton magnetic resonance spectroscopy (MRS). Materials and Methods: Sixty-six patients with known or suspected nonalcoholic fatty liver disease (NAFLD) underwent ultrasonography (US) and magnetic resonance imaging (MRI). The qualitative sonographic score and fat quantification, measured by MRS, were the techniques used. A Kappa coefficient was used for agreement calculation, and a Fisher test was used to assess the normality of the variables. The MRS results were the gold standard for US quality assessment. Results: The agreement between MRS and US was 50% (Kappa 0.35). Ultrasonography results were more severe in 42.4% of the cases, and 66.7% of the patients had a body mass index greater than 30 ( P = .017). For diagnosis of HS, US presented 100% sensitivity, 30.8% to 60% specificity, 61.7% to 72.7% accuracy, 40% to 69.2% false-positive rate, 0% false-negative rate, 53.8% positive predictive value, and 100% negative predictive value. Conclusion: Ultrasonography is a reliable exam for detecting HS, although not for grading purposes. Therefore, US is not a good predictor of HS severity for the management and follow-up of NAFLD.

Retrospective Study of the Relationship between Variable Benign Epilepsy of Childhood with Centrotemporal Spikes and the Changes of Zinc, MRS, VEEG, and IQ Test.

Benign epilepsy in childhood with centrotemporal spikes (VBECT) has been associated with electroencephalography (EEG), but the relationship of VBECT with zinc, magnetic resonance spectroscopy (MRS), and intelligence quotient (IQ) tests is unclear. The aim of this study was to investigate the association of VBECT with zinc, MRS, EEG, and IQ tests. In this retrospective study, we selected 58 children with variable benign epilepsy with centrotemporal spikes as the experimental group. A total of 120 children with typical benign childhood epilepsy with centrotemporal spikes were selected as the control group. The zinc, MRS, EEG, and IQ test results of 178 children were measured and analyzed. The results showed that the zinc, MRS, and IQ test results of the patients in the experimental group decreased significantly. The spinal slow wave results in the experimental group showed a significant upward trend. Linear correlation analysis of zinc with MRS, EEG, and IQ tests showed that 13 pairs of indicators were significantly negatively correlated. Our results suggest the importance of zinc, MRS, EEG, and IQ during VBECT.

The Accuracy of Magnetic Resonance Imaging in Diagnosing Malignant Breast Lesions

Objective: The present research seeks to examine the diagnostic accuracy of magnetic resonance spectroscopy in the diagnosis of malignant breast lesions using histopathology as the gold standard. Study Design: Cross-sectional Place and Duration: Sadiq Abassi Hospital Bahawalpur. July-21 to Dec-21 Methods: There were 110 females were presented in this study. Patients had with suspicious palpable lesions for malignancy were included. Before any patient data was collected, they signed a permission form acknowledging they understood the risks. The kinetics and morphology of magnetic resonance spectroscopy (MRS) dynamically enhanced pictures acquired with contrast on 1.5 Tesla MRI equipment were evaluated. The choline peak (Cho) permitted by MRS was used to determine a malignancy biomarker.. Single-voxel approach was used to examine MRS' diagnostic performance in breast lesions malignancy. Comparing MRS and biopsy results was done. This version of SPSS 22.0 was used to analyse all the data. Results: Majority of the patients 50 (45.5%) were from age group 41-60years, 35 (31.8%) patients had age > 60 years and 25 (22.7%) were from age group 20-40 years. Frequency of malignant lesion by MRS was found among 92 (83.6%) cases and by histopathological results its frequency was 81 (73.6%). Ductal enhancement and peripheral enhancement were the most common morphology among patients of malignant lesion by MRS. According to MRS findings, 75% specificity,86.7% accuracy, 91%sensitivty, 79% negative predictive value (NPV) and 92.3% positive predictive value were found. Conclusion: As a main imaging tool for the diagnosis of breast lesion malignancy, MRS must be used because of its superior specificity, sensitivity, and accuracy in the characterisation of breast lumps. It has been discovered that MRS is a very specific, sensitive, and reliable diagnostic tool for detecting malignant breast cancers. Keywords: Malignant breast lesion, Histopathology, Magnetic resonance spectroscopy (MRS)

Utility of magnetic resonance spectroscopy and diffusion-weighted imaging for detecting changes in the femoral head in divers with hip pain at risk for dysbaric osteonecrosis.

Ischemia before the development of dysbaric osteonecrosis (DON) in femoral heads has never been investigated. We assessed whether quantitative magnetic resonance spectroscopy (MRS) and diffusion weighted imaging (DWI) could detect dysbaric changes in divers with hip pain. This IRB-approved exploratory study recruited 17 divers [9 with hip pain (Group 1); 8 asymptomatic (Group 2)] with normal findings on radiographs and conventional magnetic resonance imaging scans were age-, gender- and body-mass-index matched to 17 non-divers as controls (Group 1C, 2C). Apparent diffusion coefficients (ADCs) and MRS spectra were obtained from regions/voxels of interest on the femoral heads of all subjects. LCModel was used to determine water content, lipid composition, and the unsaturation index in bone marrow. Mann-Whitney non-parametric test was used to compare results of quantitative MRS and ADCs of ipsilateral femoral heads between divers and controls. MRS of the ipsilateral femoral heads revealed higher water (peak: 4.7 ppm) content, lower total lipid fraction (TLF), and higher unsaturation index (UI) of lipids in Group 1 than in Group 2 (water: P=0.040; UI: P=0.022) and Group 1C (water: P=0.027; TLF: P=0.039; UI: P=0.009). In contrast, femoral head ADCs were comparable between divers and controls. Five out of nine symptomatic divers were contacted for follow-up MRS and DWI studies, and the mean difference in water content in the femoral heads of patients with osteonecrosis was also higher than that in patients with symptom relief (osteonecrosis: 0.077±0.130 vs. symptom relief: 0.003±0.010). Dysbaric change in the femoral heads of divers with hip pain can be detected using quantitative MRS, which reveals increases in water content and UI of lipids, and a decrease in TLF.

Semi-Automated Glioblastoma Tumor Detection based on Different Classifiers using Magnetic Resonance Spectroscopy

Purpose: Glioblastoma Multiform (GBM) is one of the most common and deadly malignant brain tumors. Surgery is the primary treatment, and careful surgery can minimize recurrence odds. Magnetic Resonance Imaging (MRI) imaging with Magnetic Resonance Spectroscopy (MRS) is used to diagnose various types of tumors in the Central Nervous System (CNS). In this study, several classification methods were used to separate tumor and healthy tissue.
 Materials and Methods: This study examined the MRI and MRS results of seven people enrolled in this study in 2018. The data was obtained with a prescription from a neurologist and neurosurgeon. Choline (Cho) and N-Acetylaspartate (NAA) metabolite signals were selected as the reference signal after preprocessing and removing the water signal. With the support of 3 radiologists, each tumor and healthy vesicles were identified for every patient. Then, tumor and healthy voxels were separated based on Multilayer Perceptron (MLP), linear Support Vector Machine (SVM), Gaussian SVM, and Fuzzy system using the obtained values and four different methods.
 Results: Data extracted from Cho and NAA metabolites were fed into MLP, linear SVM, Gaussian and Fuzzy SVM as input, and the amounts of accuracy, sensitivity, and specificity were determined for each method. The maximum accuracy for training mode and test mode was equal to 89.7% and 87%, respectively, specific to classification using Gaussian SVM. The results also showed that the classification accuracy can be significantly increased by increasing the number of fuzzy membership functions from 2 to 6.
 Conclusion: The results of this study suggested that a more complex classification system, such as SVM with a Gaussian kernel and fuzzy system can be more efficient and reliable when it comes to separating tumor tissue from healthy tissues from MRS data.

The role of magnetic resonance spectroscopy in differentiation of neoplastic from non-neoplastic pediatric intracerebral brain lesions

Background Pediatric brain tumors are considered a significant health problem and present several imaging challenges. The role of imaging is no longer limited to merely providing anatomical details. In this research, we explained the role of magnetic resonance spectroscopy (MRS) in the differentiation of neoplastic from non-neoplastic intracerebral brain lesions in pediatric patients. The aim was to assess the role of MRS in pediatric brain tumors by discrimination between tumors and tumor-like lesions, differentiation between primary and secondary neoplasms, differentiation between high-grade and low-grade tumors, and determination of tumor extension. Patients and methods A total of 30 pediatric patients with cerebral lesions were examined by MRS. Choline (Cho), creatine (cr), N-acetylaspartate (NAA), and lipid-lactate peaks were evaluated. Of the 30 patients, 26 underwent stereotactic biopsy. Histopathological results were compared with the MRS results. Results Diagnostic accuracy of spectroscopic data for prediction of neoplastic lesions in the current study was assessed. Regarding Cho/NAA, a cutoff point greater than 2 had 88% sensitivity and 75% specificity for prediction of neoplastic lesions, with areas under the curve (AUC) of 0.91 (P = 0.01). Regarding Cho/Cr, a cutoff point greater than 1.86 had 85% sensitivity and 75% specificity for prediction of neoplastic lesions, with AUC of 0.85 (P = 0.02). Regarding Cho/NAA+Cr, a cutoff point greater than 0.8 had 88% sensitivity and 100% specificity for prediction of neoplastic lesions, with AUC of 0.91 (P = 0.009). Conclusion MRS can potentially overcome the limitations of sampling errors with histopathologic grading of the tumor for determining the most optimal therapy regimen and regularity and aggressiveness of postoperative follow-up and treatment.

USEFULNESS OF PREOPERATIVE MAGNETIC RESONANCE SPECTROSCOPY FOR IMPROVING DONOR SAFETY

Introduction: Steatosis of liver graft is an important factor in liver transplantation that determines graft function for recipient and recovery of the remnant liver in living donors. We analyzed the data of living donors to evaluate whether magnetic resonance spectroscopy (MRS) can replace liver biopsy. Patients and Method: From May 2010 to May 2019, a total of 239 living donor data were collected. Group 1 included 73 living donors evaluated by preoperative magnetic resonance imaging (MRI) from August 2013 to January 2016. Group 2 included 82 living donors evaluated by preoperative MRS from February 2016 to May 2019. The result of the preoperative liver biopsy was compared to preoperative MRI and MRS data. Steatosis was defined by the degree of macrosteatosis. Result: Previous MRI fat fraction was a good parameter to predict between normal and fatty liver groups (3.09±3.38% vs. 7.48±4.07%, p<0.001). MRS fat fraction was also a good parameter (2.09±1.43% vs. 6.89±2.68%, p<0.001). Linear regression between the MRS and pathology results was correlated (p<0.001, R2=0.604). The sensitivity and specificity for the detection of liver steatosis in MRS were 94% and 96.9%, respectively with a cutoff of 3.75% and area 0.958 Conclusion: Preoperative MRI and MRS were both good modalities for the prediction of the normal and fatty content and showed a good correlation with the pathology grading. Especially, MRS, a non-invasive method for determining the degree of the steatosis of the liver, can be an efficient and accurate method. Preoperative MRS can also provide the anatomical variation of the bile duct which is helpful for improving living donor safety.

Combination treatments with therapeutic hypothermia for hypoxic‐ischemic neuroprotection

Therapeutic hypothermia is now proven to reduce death or disability in term and near-term born infants with moderate to severe hypoxic-ischemic encephalopathy. Nevertheless, many infants still survive with disability, despite treatment with hypothermia. Recent preclinical and clinical studies suggest that current protocols for therapeutic hypothermia are near-optimal. The obvious strategy, in addition to improving early initiation of therapeutic hypothermia after birth, is to combine hypothermia with other neuroprotective agents. We review evidence that the mechanisms of action of many promising agents overlap with the anti-excitotoxic, anti-apoptotic, and anti-inflammatory mechanisms of hypothermia, leading to a lack of benefit from combination treatment. Moreover, even apparently beneficial combinations have failed to translate in clinical trials. These considerations highlight the need for preclinical studies to test clinically realistic protocols of timing and duration of treatment, before committing to large randomized controlled trials.

The diagnostic value of MR spectroscopy versus DWI-MRI in therapeutic planning of suspicious multi-centric cerebral lesions

BackgroundA broad spectrum of non-neoplastic lesions can radiologically mimic cerebral neoplasms. Magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and diffusion-weighted imaging (DWI) are the most extensively used for enabling lesional characterization of different brain disorders. We aimed to assess the diagnostic value of MRS versus DWI in the diagnosis and therapeutic planning of multicentric cerebral focal lesions and in our retrospective study, we enrolled 64 patients with 100 brain lesions who underwent pre- and post-contrast MRI, MRS, and DWI. Diagnoses supplied by the histopathology and follow up clinical results as a gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated.ResultsConventional MRI poorly differentiates multiple cerebral lesions with 89.33% sensitivity, 44.4% specificity, and 78% accuracy. MRS results revealed statistical significance for differentiating neoplastic from non-neoplastic lesions as regards Cho/Cr, Cho/NAA, and NAA/Cr ratios (M ± SD) with P < 0.001 (significant), and there is statistical significance for neoplastic lesion differentiation when Cho/NAA and Ch/Cr ratios measured in the pre-lesional areas outside the tumor margin. DWI showed mixed diffusion changes in most of the studied lesions and the measured ADC values ranges showed overlap in neoplastic and non-neoplastic lesions, P value = 0.236* (insignificant).ConclusionMRS was found to be a more accurate diagnostic tool than DWI with ADC measurements in the differentiation and therapeutic planning of multicentric cerebral focal lesions.

Water T2 Mapping in Fatty Infiltrated Thigh Muscles of Patients With Neuromuscular Diseases Using a T2 -Prepared 3D Turbo Spin Echo With SPAIR.

Muscle water T2 (T2w ) has been proposed as a biomarker to monitor disease activity and therapy effectiveness in patients with neuromuscular diseases (NMD). Multi-echo spin-echo (MESE) is known to be affected by fatty infiltration. A T2 -prepared 3D turbo spin echo (TSE) is an alternative method for T2 mapping, but has been only applied in healthy muscles. To examine the performance of T2 -prepared 3D TSE in combination with spectral adiabatic inversion recovery (SPAIR) in measuring T2w in fatty infiltrated muscles based on simulations and in vivo measurements in thigh muscles of patients with NMD. Prospective. One healthy volunteer, 34 NMD patients. T2 -prepared stimulated echo acquisition mode (STEAM) magnetic resonance spectroscopy (MRS), SPAIR STEAM MRS, and SPAIR T2 -prepared STEAM MRS were performed in the subcutaneous fat of a healthy volunteer's thigh. T2 mapping based on SPAIR 2D MESE and SPAIR T2 -prepared 3D TSE was performed in the NMD patients' thigh region. Multi-TE STEAM MRS was performed for measuring a reference T2w at different thigh locations. The behavior of the fat spectrum in the SPAIR T2 -prepared 3D TSE was simulated using Bloch simulations. The in vivo T2 results of the imaging methods were compared to the in vivo T2w MRS results. Pearson correlation coefficient with slope and intercept, relative error. The simulated T2 for the SPAIR T2 -prepared 3D TSE sequence remained constant within a relative error of not more than 4% up to a fat fraction of 80%. In vivo T2 values of SPAIR T2 -prepared 3D TSE were in good agreement with the T2w values of STEAM MRS (R = 0.86; slope = 1.12; intercept = -1.41 ms). In vivo T2 values of SPAIR 2D MESE showed large deviations from the T2w values of STEAM MRS (R = 0.14; slope = 0.32; intercept = 38.83 ms). The proposed SPAIR T2 -prepared 3D TSE shows reduced sensitivity to fatty infiltration for T2w mapping in the thigh muscles of NMD patients. 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:1727-1736.

Decreased water T2 in fatty infiltrated skeletal muscles of patients with neuromuscular diseases.

Quantitative imaging techniques are emerging in the field of magnetic resonance imaging of neuromuscular diseases (NMD). T2 of water (T2w ) is considered an important imaging marker to assess acute and chronic alterations of the muscle fibers, being generally interpreted as an indicator for "disease activity" in the muscle tissue. To validate the accuracy and robustness of quantitative imaging methods, 1 H magnetic resonance spectroscopy (MRS) can be used as a gold standard. The purpose of the present work was to investigate T2w of remaining muscle tissue in regions of higher proton density fat fraction (PDFF) in 40 patients with defined NMD using multi-TE single-voxel 1 H MRS. Patients underwent MR measurements on a 3T system to perform a multi-TE single-voxel stimulated echo acquisition method (STEAM) MRS (TE=11/15/20/25(/35) ms) in regions of healthy, edematous and fatty thigh muscle tissue. Muscle regions for MRS were selected based on T2 -weighted water and fat images of a two-echo 2D Dixon TSE. MRS results were confined to regions with qualitatively defined remaining muscle tissue without edema and high fat content, based on visual grading of the imaging data. The results showed decreased T2w values with increasing PDFF with R2 =0.45 (p<10-3 ) (linear fit) and with R2 =0.51 (exponential fit). The observed dependence of T2w on PDFF should be considered when using T2w as a marker in NMD imaging and when performing single-voxel MRS for T2w in regions enclosing edematous, nonedematous and fatty infiltrated muscle tissue.

Brain metabolic alterations in patients with long-term calcineurin inhibitor therapy after liver transplantation.

Calcineurin inhibitor (CNI) neurotoxicity after liver transplantation might be due to impairment of the cerebral metabolism. To investigate CNI-related alterations of brain metabolite distributions and associations between cognitive function and brain metabolism in patients with long-term CNI treatment after liver transplantation. Eighty-two patients (19 CNI free, 34 CNI low-dose and 29 standard-dose CNI immunosuppression) 10years after liver transplantation and 32 adjusted healthy controls underwent nonlocalised brain phosphorus magnetic resonance spectroscopy (MRS) and single voxel proton MRS in the parietal white matter to estimate brain metabolite contents. The MRS results were correlated with psychometric data assessing cognitive function. Phosphorus metabolite concentrations with the exception of phosphocreatine (PCr) were reduced in patients compared to controls. Particularly, patients with low-dose CNI therapy showed a significant decrease in adenosine triphosphate (0.209±0.012 vs 0.222±0.010; P<0.001) and a significant increase in PCr (0.344±0.026 vs 0.321±0.017; P<0.001) compared to controls. Myo-Inositol in the CNI free group (2.719±0.549 institutional unit [iu]) was significantly lower compared to controls (3.181±0.425 iu; P=0.02), patients on low-dose (3.130±0.513 iu; P<0.05) and standard-dose CNI therapy (3.207±0.632 iu; P<0.02). Glutamate and glutamine levels correlated negatively with cognitive function (Repeatable Battery for the Assessment of Neuropsychological Status Total Scale: R=-0.362, P=0.029). Long-term CNI therapy after liver transplantation might be associated with alterations of brain metabolites.

1H-MRS Quantitation of Age-Dependent Taurine Changes in Mouse Brain.

A mouse model of Alzheimer's disease demonstrates reduced beta-amyloid levels in the whole brain, associated with a gain of hippocampal memory, after drinking taurine-enriched water; this suggests that a taurine supplement could be a promising treatment for cognitive deficit. The objective of this study is to establish a methodology for quantifying taurine in the whole brain, taking advantage of the rapid development of non-invasive imaging techniques such as magnetic resonance imaging and magnetic resonance spectroscopy (MRS). Single-voxel proton MRS was used to obtain quantifiable taurine peaks at 3.25 and 3.43ppm. Quantitative MRS results were obtained in C57BL/6 mice of various age groups: 4, 11, 18, and 27months old. Compared with the 4-month-old group, taurine levels dropped significantly only at 27months of age (p = 0.03). However, a significant decrease of N-acetyl-aspartate (NAA) in the brain was observed at both 18 and 27months (p = 0.03 and p = 0.02). In addition, MRS-measured taurine level is highly correlated with hippocampal volume (r = 0.95). These results suggest that decreased taurine levels in the brain could be used as biomarkers for hippocampal changes and are fully translatable into putative cognitive loss in both animal models and human studies without the ex vivo approach.

Magnetic Resonance Spectroscopy Features of the Visual Pathways in Patients with Glaucoma.

The aim of the study was to investigate any metabolic changes on magnetic resonance spectroscopy (MRS) throughout the visual pathway of the brain in patients with glaucoma and a control group and correlate the results with clinical findings. A total of 87 patients were enrolled in the study, 30 healthy controls, 25 glaucoma, 16 suspected glaucoma (GS) and 16 ocular hypertension (OHT) patients. Asingle voxel MRS on TE 30 ms was performed by placing the volume of interest (VOI) on the corpus geniculatum laterale (CGL) and primary visual cortex (VC). Peak values of metabolites, such as N‑acetyl aspartate (NAA), creatine (Cr), choline (Cho) and Myo-inositol (Ins) were investigated on MRS. The MRS results were correlated with age, intraocular pressure (IOP), retinal nerve fiber length (RNFL), mean deviation (MD) and cup disk ratio (CD). The NAA values obtained from the CGL in glaucoma and GS cases were lower than the healthy control group. The Cho values at CGL in glaucoma were lower than GS and controls. There was anegative correlation between NAA values of the VC and CD in glaucoma cases. Additionally, there was anegative correlation between age and RNFL in both glaucoma and GS cases. The use of MRS can reveal neurodegeneration in CGL and VC in patients with glaucoma. Depiction of metabolic changes throughout the visual pathways via MRS will guide the treatment planning and follow-up in glaucoma and GS cases.

Magnetic Resonance Spectroscopy in Living-Donor Liver Transplantation

ObjectiveThe purpose of this study is to evaluate the accuracy rate of the one breath-hold single voxel hydrogen-1 magnetic resonance spectroscopy (MRS) in comparison with intraoperative biopsy for liver fat quantification in living-donor liver transplantation. Materials and MethodsA total of 80 living liver donors participated in this study. Each patient underwent both MRS and intraoperative biopsy for evaluation of liver fatty content. MRS was performed using 1.5-T magnetic resonance imaging and placed in segments 2–4, 5–8, and left lateral segment for each donor. Accuracy was assessed through receiver operating characteristic curve analysis. Sensitivity and specificity of MRS fat fractions were also calculated. ResultsEighty living-donor liver transplantation donors were enrolled in this study. There was no fatty liver in 59 subjects (73.8%), 5% to 10% fatty liver in 17 subjects, 11% to 15% fatty liver in 3 subjects, and >16% fatty liver in 1 subject. MRS fat fraction showed excellent parameters to predict between normal liver and fatty liver groups (1.85% ± 0.98, 8.13% ± 3.52, respectively; P < .0001). Linear regression between MRS fat fraction and pathology grading showed high correlation (R2 = 0.7092). Pearson correlation revealed high correlation between MRS and pathology results (r = 0.936), poor correlation between body mass index and pathology results (r = 0.390). The sensitivity and specificity for detection of liver steatosis in MRS fat fraction were 95.2% and 98.3%, respectively. Conclusion1H MRS fat fraction is a highly precise and accurate method in quantification of hepatic steatosis for the living donor and can be finished in a single breath-hold.

THE RELATION BETWEEN CLINICAL, EPILEPTIFORM DISCHARGES, AND NEUROMETABOLIC DYSFUNCTION IN TEMPORAL LOBE EPILEPSY

Background: Temporal lobe epilepsy (TLE) is the most frequent cause of focal and refractory seizures. Magnetic Resonance Spectroscopy (MRS) is a potentially useful tool in the investigation of brain metabolites in TLE. Objective: to clarify the role of MRS in the TLE epilepsy and to evaluate the relationship between the results of MRS, Electroencephalography (EEG), and the clinical data of TLE patients with negative Magnetic Resonance imaging (MRI). Patients & Methods: Thirty patients with TLE and negative MRI were investigated by EEG, MRS and neuropsychological tests that assessed memory function of temporal lobe. By using temporal metabolite identified on MRS, we could detect metabolic disturbance that occur in TLE and tried to lateralize epileptic focus. We correlated MRS results with, EEG results, and the patient's scores on memory function tests. Twenty age-matched volunteers were used as control subjects. Result(s): Ipsilateral temporal N-acetyl-aspartate (NAA)/ Creatine+Choline (Cr+Cho) and NAA/Cr ratios of the patients were significantly reduced compared with the mean ratios of contralateral hippocampus (p <0.001) and control subjects (p <0.001). EEG could detect epileptic focus in 17 (56.7%) patients, while MRS could detect epileptic focus in 27 (90%) patients and could lateralize about 76.9% of patients with bitemporal interictal epileptiform discharges (IEDs). Significant negative correlation between ipsilateral temporal NAA/Cr+Cho, NAA/Cr ratios and ipsilateral IEDs ratio (p < 0.05). Left temporal NAA/Cr ratio correlated significantly with patient's scores on Rey Auditory Verbal Learning Test (RAVLT) (p< 0.05) and right temporal NAA/Cr ratio correlated significantly with patient's scores on Rey Complex Figure Test (RCFT) (p < 0.05). Conclusion(s): These findings suggested that the temporal metabolite ratios identified on MRS could lateralize epileptic focus in TLE patients and they are closely related to the temporal IEDs and the cognitive function of temporal lobe. Key Words: temporal lobe epilepsy, Magnetic resonance spectroscopy, EEG, memory.

Longitudinal assessment of oxytocin efficacy on bone and bone marrow fat masses in a rabbit osteoporosis model through 3.0-T magnetic resonance spectroscopy and micro-CT.

This study aims to longitudinally assess the effect of oxytocin on bone and bone fat masses using micro-CT, in vivo magnetic resonance spectroscopy (MRS), and histopathological adipocyte quantification. Early in vivo oxytocin (OT) treatment to the osteoporosis (OP) rabbit model may reliably inhibit bone degeneration and reduce bone marrow fat accumulation by decreasing marrow adipocyte size and density. This study aims to longitudinally assess the effect of early OT treatment on bone and bone fat masses in a rabbit OP model by comparing the results of MRS and micro-CT with histopathological findings. Sixty 20-week-old female rabbits were randomly assigned into three groups. The control and OP groups were subjected to either sham surgery or bilateral ovariectomy (OVX). The OT group was subcutaneously injected with OT daily from the second week after OVX for 8 weeks. The left proximal femurs of the rabbits were evaluated through MRS, micro-CT, and histopathological examination at 0, 4, 8, 10, and 12 weeks after operation. Differences in fat fraction (FF) values, micro-CT parameters, and calculated pathological marrow adipocytes among three groups were analyzed. The FF values of the OP group significantly increased (p = 0.019), but the tissue mineral density (TMD) decreased (p = 0.037) from eighth week compared with those of the control group. The FF values of the OT group significantly decreased (p = 0.044), but the TMD values increased (p = 0.042) from eighth week compared with those of the OP group. The adypocyte diameter of the OT group significantly decreased (p = 0.041) from eighth week and then adypocyte density did so too from tenth week, compared with those of the OP group at the same time point. No difference in adypocyte calculation was found between the OT and control groups until the 12th week after operation. Early in vivo OT treatment slowed down bone deterioration and reduced bone marrow adiposity accumulation in a rabbit OP model, which is consistent with pathologic findings. OT treatment is a promising preventive OP therapy.

Advanced Magnetic Resonance Imaging Findings of Renal Hydatid Cyst

Abstract Hydatid Cyst, a serious health problem in the developing countries, is a zoonotic infection formed by echinococcus. Though liver or lung involvement is often, kidney involvement is rarely seen and represents for only 2 to 3 per cent of all cases of hydatid disease. An adult case referred who had multiple cysts in liver and large, solitary cyst in the kidney. We aimed to present magnetic resonance spectroscopy (MRS) and diffusion weighted magnetic resonance (DWI) findings of the hydatid cyst’s. This is the first study that shows the MRS and DWI results of the renal hydatid disease. The mean ADC (apparent diffusion coefficient) value of the renal hydatid cyst was 2554x10-6 mm2/s on DWI and high signal intensity was detected compared with the renal parenchyma. MR spectroscopy at TE of 31 shows prominent alanine peak in addition to small amino acid peaks. Advanced MRI studies such as DWI and MRS can provide supplementary information both in the post-treatment period and in the diagnosis by bringing non-invasive approaches. Key words: Hydatid Cyst, magnetic resonance imaging, magnetic resonance spectroscopy, diffusion weighted imaging