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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 27:2210-2213, November-December 2006
© 2006 American Society of Neuroradiology

Case Report
HEAD & NECK

MR Spectroscopy in Sinus Mucocele: N-Acetyl Mimics of Brain N-Acetylaspartate

E. Andre^a, M. Xu^a,b, D. Yang^d,e, J.K. Siow^f, T.T. Yeo^g, Y. Xu^d and C.C.T. Lim^a,c

^a Department of Neuroradiology, National Neuroscience Institute, Singapore
^b Department of Radiology, Affiliated First Hospital of Zhejiang Chinese Medical University, Singapore
^c Department of Diagnostic Radiology, National University of Singapore, Singapore
^d Department of Chemistry, National University of Singapore, Singapore
^e Department of Biological Sciences, National University of Singapore, Singapore
^f Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore
^g Department of Neurosurgery, National Neuroscience Institute, Singapore

Please address correspondence to: C.C.T. Lim, MD, Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433; e-mail: tchoyoson_lim{at}nni.com.sg

SUMMARY: We describe MR spectroscopy in 2 patients with frontal sinus mucoceles that showed a dominant metabolite peak at 2.0-ppm chemical shift, simulating N-acetylaspartate (NAA) of normal neuronal tissue. In vitro analysis of postsurgical mucocele samples confirmed that the signal at 2.0 ppm was arising from the methyl moiety of an N-acetyl compound. This is probably caused by N-acetylgalactosamine or N-acetylglucosamine, which are glycoproteins found in normal respiratory mucus produced by the paranasal sinus epithelium.