Clinical MR Spectroscopy: Techniques and Applications

Half-title......Page 3
Title......Page 5
Copyright......Page 6
Contents......Page 7
Preface......Page 9
Acknowledgments......Page 10
Abbreviations......Page 11
Nuclear magnetic resonance spectroscopy......Page 13
Signal and signal-to-noise ratio......Page 14
Relaxation times......Page 15
Chemical shifts......Page 16
Spin–spin (scalar) coupling constants......Page 17
Fourier transform spectroscopy......Page 18
In vivo MR spectroscopy......Page 19
Information content of proton MR spectra of the brain......Page 21
NAA......Page 22
Choline......Page 23
Glutamate and glutamine......Page 25
References......Page 26
Single-voxel techniques......Page 31
Multiple-voxel (spectroscopic imaging) techniques......Page 33
Spatial resolution and scan time in MRSI......Page 35
Fast MRSI techniques......Page 36
Lipid suppression......Page 37
Spectral editing sequences using selective pulses......Page 38
MRS with multiple RF receiver coils......Page 39
Recommended acquisition protocols......Page 40
Temporal lobe epilepsy (TLE)......Page 41
Supra- and infra-tentorial multi-slice MRSI......Page 42
References......Page 43
Time domain processing......Page 46
Frequency domain processing......Page 48
MRSI processing techniques......Page 49
Spectral fitting......Page 50
Quantitation methods......Page 51
Units and tissue compartmentalization......Page 53
Inadequate field homogeneity......Page 54
Incorrect voxel (or MRSI slice) placement......Page 56
Chemical shift displacement effects......Page 57
Can MRS be performed after administration of Gd contrast?......Page 59
References......Page 60
Anatomical variations in brain spectra: young adults......Page 63
Age-related variations in brain spectra: early brain development in children......Page 67
Age-related variations in brain spectra: the elderly brain......Page 68
Conclusions......Page 69
References......Page 71
New concepts about brain tumor initiation, transformation, and diffusion......Page 73
Histopathological classification of brain tumors......Page 76
WHO grading and patient survival......Page 77
Semiotics of proton MR spectroscopy in brain tumors......Page 78
Is it a tumor?......Page 88
What’s the grade of this glioma?......Page 89
Can MRS predict patient survival?......Page 91
Is it an oligodendroglioma?......Page 92
MRS imaging-guided therapy planning and monitoring......Page 94
Special considerations about pediatric brain tumors......Page 95
Conclusions......Page 97
References......Page 98
NAA......Page 103
Metabolic changes during ischemia: animal models......Page 105
Metabolic changes in human stroke......Page 106
MR spectroscopy in hypoxic–ischemic encephalopathy......Page 107
Normal neonatal brain MRS......Page 109
1H MRS in HIE......Page 112
Diffusion MRI in HIE: comparison to 1H MRS......Page 114
References......Page 117
Intracranial infections......Page 122
Brain abscesses......Page 123
Tuberculoma......Page 124
HIV encephalopathy......Page 126
Toxoplasmosis and primary CNS lymphoma......Page 127
Progressive multifocal leukoencephalopathy......Page 129
1H-MRS......Page 130
Multiple sclerosis......Page 131
Acute disseminated encephalomyelitis......Page 134
References......Page 136
Introduction......Page 143
31P MRS......Page 144
Proton MRS......Page 145
Temporal lobe epilepsy......Page 146
Diffuse metabolic abnormalities in temporal lobe epilepsy......Page 147
MRS in TLE cases where MRI is normal, or symmetrically abnormal......Page 148
Neurotransmitters: brain GABA levels......Page 149
Some recommendations for MRS protocols for patients with epilepsy......Page 150
References......Page 151
Dementia......Page 156
1H-MRS......Page 157
Vascular dementia......Page 159
Dementia with Lewy bodies......Page 161
Parkinson’s disease and related disorders......Page 162
Huntington’s disease......Page 163
Human prion diseases......Page 164
1H-MRS......Page 165
References......Page 166
 Introduction......Page 173
MRI in the diagnosis of TBI......Page 174
Magnetic resonance spectroscopy......Page 175
Metabolic changes and prediction of outcome......Page 176
Diffuse metabolic abnormalities......Page 177
Cognitive function and metabolism......Page 178
Adult TBI......Page 179
Neuropsychological correlation and vegetative state patients......Page 180
Microdialysis studies in TBI: Relevance to MRS......Page 181
Magnetic resonance spectroscopic imaging studies in TBI......Page 182
Metabolic changes in the early stages of TBI......Page 184
Volumetric and whole-brain spectroscopy studies in TBI......Page 185
References......Page 186
Classification of metabolic disorders......Page 192
Conventional MR imaging......Page 193
Creatine deficiency......Page 194
Fatty acid oxidation disorders......Page 200
MR spectroscopy......Page 201
Urea cycle defects......Page 204
Hyperhomocysteinemias......Page 206
Organic acidopathies......Page 207
Methylmalonic aciduria......Page 208
Hereditary leukoencephalopathies......Page 210
Pelizaeus–Merzbacher disease......Page 211
Metachromatic leukodystrophy......Page 212
Adrenoleukodystrophy......Page 213
Alexander disease......Page 214
Leukoencephalopathy with vanishing white matter......Page 216
Megalencephalopathy with subcortical cyst......Page 217
References......Page 219
Introduction......Page 224
Magnetic resonance imaging......Page 225
Citrate metabolism......Page 226
Magnetic resonance spectroscopy......Page 227
MRSI techniques......Page 228
Spectral interpretation......Page 231
J-coupling......Page 232
1.5 T vs. 3.0 T......Page 234
References......Page 235
Introduction: MRS of breast tissues......Page 241
Clinical background: breast cancer screening and diagnosis......Page 242
Magnetic resonance spectroscopy of breast cancer......Page 243
Monitoring treatment response......Page 245
Technical aspects of breast spectroscopy......Page 246
Water and lipid suppression......Page 247
Magnetic resonance spectroscopic imaging of the breast......Page 248
Breast spectroscopy at high magnetic fields......Page 250
Summary......Page 251
References......Page 252
Introduction......Page 255
31P-MRS in normal muscle......Page 256
31P MRS exercise-recovery paradigms: practical considerations......Page 258
Glycogenolytic and glycolytic disorders......Page 259
Mitochondrial disorders......Page 260
Muscular dystrophies......Page 261
31P-MRS of muscle in CNS disorders......Page 262
1H-MRS of muscle......Page 263
References......Page 264
Index......Page 268