Proton MR Spectroscopy of Tumefactive Demyelinating Lesions
Amit M. Saindanea,
Soonmee Chaa,
Meng Lawa,
Xiaonan Xueb,
Edmond A. Knoppa,c,d and
David Zagzagc,d,e
a Department of Radiology, New York University Medical Center, 530 First Avenue, HCC-Basement, MRI Center, NY
b Department of Environmental Medicine, New York University Medical Center, 530 First Avenue, HCC-Basement, MRI Center, NY
c Department of Neurosurgery, New York University Medical Center, 530 First Avenue, HCC-Basement, MRI Center, NY
d Department of Pathology, New York University Medical Center, 530 First Avenue, HCC-Basement, MRI Center, NY
e Division of Neuropathology, and the Kaplan Cancer Center, New York University Medical Center, 530 First Avenue, HCC-Basement, MRI Center, NY
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FIG 1. Images in a 50-year-old woman with biopsy-proven tumefactive demyelinating lesion.
A, Contrast-enhanced axial T1-weighted image (600/14/1) demonstrates an ill-defined enhancing mass (arrow) in the left frontoparietal periventricular white matter.
B, Axial T2-weighted image (3400/119/1) shows increased signal intensity (arrow) around the lesion.
C, Localizing image (600/14/1) for proton MR spectroscopy displays a voxel in the central portion of the lesion.
D, Proton MR spectrum obtained by using PRESS (1500/144) demonstrates an elevated Cho value, a decreased NAA value, and a Lac doublet.
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FIG 2. Images in an 81-year-old man with a high-grade mixed glioma.
A, Contrast-enhanced axial T1-weighted image (600/14/1) demonstrates an ill-defined enhancing mass (arrow) in the left temporal region.
B, Axial T2-weighted image (3400/119/1) shows increased signal intensity (arrow) around the lesion.
C, Localizing image (600/14/1) for proton MR spectroscopy displays a voxel in the central portion of the lesion.
D, Proton MR spectrum obtained by using PRESS (1500/144) demonstrates an elevated Cho value and a decreased NAA value.
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FIG 3. Photomicrographs of a biopsy specimen from a tumefactive demyelinating lesion in a 50-year-old woman. Left, A Luxol fast blue stain demonstrates extensive myelin loss. The lower left corner (arrow) shows a relatively normal pattern of myelination. Right, Silver stain demonstrates relative preservation of axis cylinders.
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