Brain abscess - MR spectroscopy
This case shows typical brain abscess with characteristic conventional MRI and MR spectroscopy criteria.
Although restricted diffusion is highly suggestive of brain abscess, cystic metastasis of squamous cell carcinoma and post-irradiation necrosis can show restricted diffusion.
The main MRS findings in brain tumors are :
- Decreased NAA and decreased Cr as well as decreased NAA / Cr ratio. The degree of the neuronal markers as well as the Myo-inositol reduction correlates with the high grade of the brain tumor.
- Increased choline (Cho).
- Increased lipid/lactate is noted in both tumors and abscess. BUT only abscess spectrum shows amino acids, acetate, aspartate, and succinate peaks.