AbstractPurpose Our aim is to describe the spectrum of proton-MR spectroscopy in malignant focal brain lesions and to detect grade of malignancy using \{MRS\} tumor biomarkers. Materials and methods 87 patients (63 males and 24 females) with focal brain lesion(s) are included in this study. All had a brain tumor recently diagnosed by \{MRI\} and had received no previous treatment. They were referred to \{MRS\} examination before surgical biopsy and/or resection or radiotherapy. Results In malignant brain tumors, average Cho/NAA ratio was 3.3 ± 0.22, Cho/Cr ratio was 2.95 ± 0.21, MI/NAA ratio was 1.5 ± 0.12, MI/Cr was 0.53 ± 0.11 with lower \{MI\} levels and higher choline levels in more malignant tumours, lipid/lactate peak was detected in brain metastasis and high grade malignant brain tumors. Conclusion Higher Cho/NAA, Cho/Cr and MI/NAA ratios with lower MI/Cr, and high lipid/lactate peak, were most likely to be in high grade malignant brain tumors.

Objectives

Our aim was to evaluate the efficacy of MR Spectroscopy in characterization of white matter signal abnormalities diagnosed by MRI detect changes in different metabolites and peaks of inflammation.

Patients and methods

93 patients (49 females and 44 males) age ranging from 2 to 63 years with average (37 ± 2.34 years) presented with white matter hyperintense lesions on T2 and T2 FLAIR and/or contrast enhanced T1WI diagnosed on MRI are included our study.

Results

In Infectious group: Average Cho/NAA ratio: 0.79 ± 0.19, Cho/Cr ratio: 0.95 ± 0.17, NAA/Cr 1.89 ± 0.69, in inflammatory group Cho/NAA ratio: 0.65 ± 0.15, Cho/Cr ratio: 0.98 ± 0.29, Average NAA/Cr ratio 1.69 ± 0.19. In ischemic group: Average Cho/NAA ratio: 0.83 ± 0.09, Cho/Cr ratio: 0.81 ± 0.23, Average NAA/Cr 1.54 ± 0.39, in metabolic group: Average Cho/NAA ratio: 0.57 ± 0.13, Cho/Cr ratio: 0.76 ± 0.26; NAA/Cr ratio was 1.73 ± 0.44, in mitochondrial group, Average Cho/NAA ratio: 0.62 ± 0.19, Cho/Cr ratio: 0.54 ± 0.14, NAA/Cr ratio was 1.49 ± 0.59, in inherited dysmyelinating; Cho/NAA ratio: 0.51 ± 0.17, Cho/Cr ratio: 0.63 ± 0.13; Average NAA/Cr ratio was 1.87 ± 0.65. Glutamate and myoinositol peak raised in inflammatory, infectious, metabolic, inherited, and ischemic group mainly in the acute and subacute stage. Amino acids and succinate peak specifically are raised in brain abscesses.

Conclusion

MRS is a noninvasive additional MRI technique to define the nature of non-neoplastic brain lesions. Together with image analysis, it may be the key to etiologic diagnosis or, at least, definition of the group where the lesion is classified, by detecting changes in different metabolites and peaks of inflammation.

The relationship between chronic hemolysis with subsequent iron overload, inflammation, and premature atherosclerosis has been documented in hemolytic anemias, particularly β-thalassemia. However, no such relationship has been established in sickle cell disease (SCD). We sought to evaluate SCD as a risk factor for early vascular insult by measuring carotid intima-media thickness (CIMT) and plasma chitotriosidase and to assess the role of the latter as a potential quantitative indicator of vascular inflammation and atherogenesis. Thirty SCD pediatric patients (3-18 years) and 30 matched controls were enrolled. Full clinical history, with hematological and biochemical parameters, was evaluated. CIMT and chitotriosidase activity were also assessed for all study participants. CIMT values were significantly higher in SCD patients (median 0.42; range 0.32-0.6 mm) compared to controls (0.36; 0.34-0.45 mm), P = 0.03. CIMT correlated positively with age (r = 0.460, P = 0.011), and total number of vascular incidents necessitating hospital admission (r = 0.439, P = 0.015). Similarly, chitotriosidase activity was significantly higher among SCD patients (median 59.6; range 7.3-512 nmol/ml plasma/h) compared to controls (32.7; 6.8-63.1 nmol/ml plasma/h), P < 0.001, and showed a positive correlation with serum ferritin (r = 0.517, P = 0.003) and CIMT (r = 0.535, P = 0.002). SCD children are at risk of developing premature atherogenic changes. Plasma chitotriosidase and CIMT may represent useful predictors of these changes.