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Use of serial proton magnetic resonance spectroscopy to differentiate low grade glioma from tumefactive plaque in a patient with multiple sclerosis

Lookup NU author(s): Professor David Ellison, Dr Daniel Birchall

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Abstract

We report on the use of serial proton MR spectroscopy (H-1 MRS) to differentiate between glioma and tumefactive plaque in a known multiple sclerosis (MS) patient who developed a symptomatic cerebral space occupying lesion. Gliomas and acute MS plaques may have indistinguishable chemical resonance spectra, whereas that of chronic plaque is distinct. In our case 1H MRS demonstrated elevated concentrations of choline, lactate and lipid, with reduced N-acetyl aspartate, a pattern consistent with either low grade glioma or acute demyelinating plaque. A repeat study 4 months later showed no change, this was felt to be incompatible with the natural history of an acute plaque and low grade glioma was diagnosed. Surgical removal of the lesion revealed an oligodendroglioma, confirming the imaging findings.

Publication metadata

Author(s): Butteriss DJA, Ismail A, Ellison DW, Birchall D

Publication type: Article

Publication status: Published

Journal: British Journal of Radiology

Year: 2003

Volume: 76

Issue: 909

Pages: 662-665

ISSN (print): 0007-1285

ISSN (electronic): 0961-2653

Publisher: British Institute of Radiology

URL: http://dx.doi.org/10.1259/bjr/85069069

DOI: 10.1259/bjr/85069069

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