Jebmh.com Original Research Article J. Evid. Based Med. Healthc., pISSN- 2349-2562, eISSN- 2349-2570/ Vol. 4/Issue 81/Oct. 09, 2017 Page 4805 ROLE OF MAGNETIC RESONANCE SPECTROSCOPY IN INTRACRANIAL LESIONS- A STUDY OF 75 CASES Rajendra N. Solanki 1 , Vidhi Shah 2 , Digish Vaghela 3 , Harshad Shah 4 1 Consultant Radiologist, Department of Radiodiagnosis, Radiscan Diagnostics, Vadaj, Ahmedabad. 2 Consultant Radiologist, Department of Radiodiagnosis, HCG Hospital, Ahmedabad. 3 Associate Professor, Department of Radiodiagnosis, BJ Medical College and Civil Hospital, Ahmedabad. 4 Professor, Department of Radiodiagnosis, CU Shah Medical College, Surendranagar. ABSTRACT BACKGROUND Our study have shown the role of MR spectroscopy in lesions whenever results are equivocal or non-conclusive even on MRI. MR spectroscopy can differentiate the lesions, particularly intracranial lesions on the basis of various metabolites. The aims of this study is to diagnose the intracranial lesions and to show the advantage of MR spectroscopy over the conventional MRI, to differentiate the neoplastic from non-neoplastic lesion, to prove the reliability of MR spectroscopy in identifying the different grades of glioma with histopathological correlation as well as to differentiate recurrent tumour from post-operative changes or radiation necrosis. MATERIALS AND METHODS During the period of August 2009 to July 2011, a prospective study of 75 patients was carried out at Department of Radiodiagnosis, Civil Hospital and BJ Medical College, Ahmedabad, Gujarat. MRI was performed on 1.5 Tesla MR scanner (GE HDXT) using dedicated head coil. Conventional MR imaging was performed followed by MR spectroscopy using point resolved spectroscopy. After deciding the region of interest voxel was kept and 2D multivoxel proton spectroscopy (TR- 1000 msec, TE- 144 msec, voxel size 20 x 20 mm) or single voxel proton spectroscopy (TR- 1500 msec, TE- 35 msec, voxel size 20 x 20 mm) was performed and spectra obtained. RESULTS In the present study of 75 patients, the maximum number of patients were between 31 to 50 years of age. The approximate ratio of male: female was 2: 1. In our study sensitivity, specificity, positive predictive value, negative predictive value of MRI are 89%, 87%, 87% and 89% respectively and of MRI + MRS are 100%, 97%, 97% and 100% respectively in tumours. CONCLUSION MRS (Magnetic Resonance Spectroscopy) is a non-invasive imaging technique that studies the chemical activity in the brain and detects the presence of certain chemical substances. Through this imaging technique, images and graphs of the brain can be obtained. KEYWORDS MRI (Magnetic Resonance Imaging), MRS (Magnetic Resonance Spectroscopy), Metabolites, Intracranial Lesions. HOW TO CITE THIS ARTICLE: Solanki RN, Shah V, Vaghela D, et al. Role of magnetic resonance spectroscopy in intracranial lesions- a study of 75 cases. J. Evid. Based Med. Healthc. 2017; 4(81), 4805-4817. DOI: 10.18410/jebmh/2017/959 BACKGROUND MRS scans are more precise techniques that help to determine the presence of certain molecules belonging to certain substances present in the body. A resonance frequency of the atoms is produced, which can vary depending on the specific chemical substance and can be determined with the help of MRS. 1 Since in many pathologic processes, metabolic changes precede anatomic changes during disease progression and treatment, MRS offers a method of early detection of new disease and can influence therapeutic success or failure. The nuclei with an odd number of protons and neutrons such as hydrogen-1, phosphorous-31, carbon-13 and fluorine-19 have a magnetic moment and interact with the external magnetic field and are commonly observed in MR spectroscopic studies. 2 MRS can be utilised to detect and study disorders that are inflammatory, ischaemic, neoplastic or metabolism- associated in nature. It can be used to examine several structures present in the body such as the brain, liver, kidney, prostate and the limbs. However, in human beings, MRS is frequently utilised to study disorders affecting the brain, as other techniques such as biopsy and microscopic studies cannot be performed. Frequently, MRS and MRI scans are performed together, so that the results are very specific and accurate. Financial or Other, Competing Interest: None. Submission 27-09-2017, Peer Review 29-09-2017, Acceptance 07-10-2017, Published 09-10-2017. Corresponding Author: Dr. Rajendra N. Solanki, Radiscan Diagnostics, Radiscan House, Khat Colony, Near Gopi Annakhetra, Akhabarnagar Circle, Vadaj, Ahmedabad. E-mail: solankirn@yahoo.co.in DOI: 10.18410/jebmh/2017/959