Proton (1H) MR spectroscopy for routine diagnostic evaluation of brain lesions.

PURPOSE: To describe the introduction and performance of proton MR spectroscopy (1H-MRS) in the daily routine of a modern standard MR unit.

MATERIAL AND METHODS: Over an 8-month period, 52 patients with brain lesions were studied with 1H-MRS, using SE and STEAM sequences for chemical-shift imaging and single-volume spectroscopy. The quality of the spectra was graded from 1 (best) to 3, and the main factors influencing the quality of the spectra were evaluated.

RESULTS: Of the measurements: 85% were graded as 1; 12% as 2; and 3% as 3. The main reasons for poor spectral quality were: the unfortunate positioning of the VOI; hemorrhage; and/or postoperative changes within the VOI. Of 40 patients with a final diagnosis: MRS provided an increased confidence in MR diagnosis in 18 cases; MRS contributed significantly to preoperative diagnosis in 3 cases; and the spectra were not specific (n = 10) or were difficult to evaluate (n = 9) owing to reduced quality (grade 2 or 3) in 19 cases.

CONCLUSION: MRS of the brain can provide a high percentage of interpretable spectra and frequently can increase confidence in the MR diagnosis of brain lesions in clinical routine.