MR Spectroscopy in Diagnosis and Neurological Decision-Making

Abstract

One of the most prolific chemical and anatomical imaging techniques of recent decades, magnetic resonance imaging (MRI), includes the ability to noninvasively assess neurochemical changes with magnetic resonance spectroscopy (MRS). Practical concerns are paramount in applying MRS, such as what the manufacturer provides with a routine MRI scanner, what methods are well tolerated by patients, and what has proved most diagnostically productive over a 25 year span of preliminary exploration of the technology. In this review, the authors explain the technical and neurochemical aspects of MRS and critically discuss its clinical neuroimaging applications.

Neuroimaging in Mitochondrial Disorders

“…These are membrane and myelin markers, and can increase with pathological changes to membrane turnover [34]. Fluctuations in total Choline compounds occur with diffuse axonal injury [25] among other findings. The major resonance of creatine is present at 3.00 ppm, and in a healthy brain it is comprised of equal proportions of free creatine and phosphocreatine, with creatine and phosphocreatin in constant enzymatic exchange.…”

“…These spectra contain information regarding brain metabolite concentrations relevant to a variety of neurological conditions, including brain tumors, traumatic brain injury, white matter disorders, epilepsy, and metabolic disorders [25].…”

Glial Dysfunction in Abstinent Methamphetamine Abusers

“…Because tCr has been used successfully as an internal metabolite reference in several proton MRS studies in abstinent methamphetamine users (Nordahl et al, 2005(Nordahl et al, , 2002Salo et al, 2007) as well as other human studies (see review, Xu et al, 2008), and does not become enriched during the time scale of the present studies, we have used this as an internal reference to quantify HCO 3 À and its subsequent enrichment from [1-…”

Detection of oncogenic IDH1 mutations using magnetic resonance spectroscopy of 2-hydroxyglutarate

“…Relative quantification, typically employed in clinical exams, is also affected by confounding effects due to changes in the reference metabolite (49).…”