The Role of Spectral Resonance Imaging in The Diagnosis and Evaluation of Various Brain Lesions

Abstract Background: Magnetic Resonance Spectroscopy (MRS) is a recently discovered safe diagnostic tool, which measures the concentration of metabolites in brain tissues and lesions studied by magnetic resonance. Objective: To highlight and activate this modern diagnostic procedure and benefit from it in diagnosing brain tumors, white matter lesions, studying tumor necrosis cases, radiation necrosis, and other brain lesions. Study Method: This technique was adopted at Al-Mouwasat University Hospital starting from 2010 and the study was conducted as a complementary study to solve many neurological diagnostic dilemmas. The study was conducted in the Radiology Department at Al-Mouwasat University Hospital and some cases from private hospitals in Damascus city in cooperation with the Neurology and Neurosurgery departments. The study is based on performing an MRI then determining the region for which we perform Magnetic Resonance Spectroscopy that shows brain metabolites such as Choline - Creatine - Alanine - N-acetyl aspartate - Lactate - Lipids, and others. Results: Through the follow-up of clinical cases and the application of different spectral diagram analysis, an increase in the diagnosis of tumorous and non-tumorous brain lesions was noticed with very high diagnostic accuracy especially in evaluating cases after surgical intervention and radiation therapy. Magnetic Resonance Spectroscopy technique has boosted the diagnosis of gliomas to 88%, and also the measurement of Choline value can be relied upon in confirming the diagnosis of brain tumors as it increases by 88% and helps in evaluating tumor necrosis after intervention. The study was conducted on the Lactate metabolite where its severe increase was noticed in cases of cerebral infarction to a rate exceeding 90% and it increases by 78% from cases of cerebral impairment due to oxygen deficiency. Conclusion: Magnetic Resonance Spectroscopy is an important and effective diagnostic tool in evaluating neurological lesions. It was adopted globally and applied on a limited scale in Damascus city and was activated in the MRI unit and Radiology department at Al-Mouwasat University Hospital. The aim of this study is to highlight it and draw the attention of clinicians in order to reach a certain or accurate diagnosis for cases and various diagnostic dilemmas for the benefit of patients and to alleviate the burden on surgeons and clinicians.