Application of magnetic resonance spectroscopy in the differentiation of high-grade brain neoplasm and inflammatory brain lesions

This study aims at evaluating the application of magnetic resonance spectroscopy (MRS) in the differential diagnosis of brain tumors and inflammatory brain lesions. The examinations of 81 individuals, who performed brain MRS and were retrospectively analyzed. The patients with ages between 10 and 80 years old, were divided into two groups. Group A consisted of 42 individuals with diagnoses of cerebral toxoplasmosis and Group B was formed of 39 individuals with diagnosis of glial neoplasms. On analyzing the ROC curve, the discriminatory boundary for the Cho/Cr ratio between inflammatory lesions and tumors was 1.97 and for the NAA/Cr ratio it was 1.12. RMS is an important method useful in the distinction of inflammatory brain lesions and high-degree tumors when the Cho/Cr ratio is greater than 1.97 and the NAA/Cr ratio is less than 1.12. And so this method is important in the planning of treatment and monitoring of the therapeutic efficiency.

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Application of Magnetic Resonance Spectroscopy in the Differentiation of High-Grade Brain Neoplasm and Inflammatory Brain Lesions

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v5i8.184 ◽

2017 ◽

Vol 5 (8) ◽

Author(s):

Prafulla Kumar Dash ◽

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Spectroscopy ◽

Brain Neoplasm ◽

Brain Lesions ◽

Resonance Spectroscopy ◽

High Grade

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Hepatorenal index for grading liver steatosis with concomitant fibrosis

PLoS ONE ◽

10.1371/journal.pone.0246837 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246837

Author(s):

Fabio Lucio Stahlschmidt ◽

Jean Rodrigo Tafarel ◽

Carla Martinez Menini-Stahlschmidt ◽

Cristina Pellegrino Baena

Keyword(s):

Liver Disease ◽

Magnetic Resonance ◽

Magnetic Resonance Spectroscopy ◽

Fatty Liver Disease ◽

Ultrasound Elastography ◽

Resonance Spectroscopy ◽

Observer Variability ◽

Advanced Fibrosis ◽

Group A ◽

Group B

Introduction Ultrasonography is widely used as the first tool to evaluate fatty liver disease, and the hepatorenal index is a semi-quantitative method that improves its performance. Fibrosis can co-exist with steatosis or even replace it during disease progression. This study aimed to evaluate the influence of fibrosis on the measurement of steatosis using the hepatorenal index. Materials and methods This cross-sectional study included 89 patients with nonalcoholic fatty liver disease and in whom liver fibrosis was determined by ultrasound elastography. The Pearson’s correlation coefficient was used to compare between the results of the sonographic hepatorenal index and the quantification of steatosis using magnetic resonance spectroscopy as well the accuracy of detecting moderate to severe steatosis using sonography in two groups of patients: (A) without advanced fibrosis and (B) with advanced fibrosis. Advanced fibrosis was defined as a shear wave speed ≥ 1.78 m/s on ultrasound elastography. We calculated the area under the curve (AUC-ROC) to detect the ability of the hepatorenal index to differentiate light from moderate to severe steatosis in both groups. Moderate to severe steatosis was defined as a fat fraction > 15% on the magnetic resonance spectroscopy. The intra-observer variability was assessed using the Bland-Altman plot. Results Among patients, the mean age was 54.6 years and 59.6% were women, 50.6% had a body mass index ≥ 30 kg/m2, 29.2% had moderate to severe steatosis, and 27.2% had advanced fibrosis. There was a correlation between steatosis grading by ultrasonography and magnetic resonance in group A (0.73; P < 0.001), but not in Group B (0.33; P = 0.058). The AUC-ROC for detecting a steatosis fraction ≥ 15% was 0.90 and 0.74 in group A and group B, respectively. The intra-observer variability for the hepatorenal index measurements was not significant (-0.036; P = 0.242). Conclusion The hepatorenal index is not appropriate for estimating steatosis in livers with advanced fibrosis.

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