MAGNETIC RESONANCE IMAGING AND PROTON MR SPECTROSCOPY IN THE DIFFERENTIAL DIAGNOSIS OF INTRACRANIAL BRAIN TUMORS

Abstract

Background. Magnetic resonance imaging (MRI) is the primary modality for structural assessment of intracranial tumors; however, conventional MRI sequences do not always allow reliable differentiation between neoplastic and non-neoplastic lesions or accurate grading of tumor malignancy. Proton magnetic resonance spectroscopy (¹H-MRS) provides additional metabolic information that significantly enhances diagnostic accuracy.

Objective. To analyze the diagnostic value of conventional MRI combined with proton MR spectroscopy in the differentiation of intracranial tumors and non-tumor brain lesions, as well as in the assessment of tumor histological type and malignancy grade.

Materials and Methods. A narrative review of international and regional literature focusing on MRI pulse sequences, technical aspects of single-voxel and multivoxel ¹H-MRS, metabolite profiles, and metabolite ratio analysis in intracranial tumors.

Results. Characteristic metabolic patterns of intracranial tumors include decreased N-acetylaspartate (NAA), increased choline (Cho), reduced creatinine (Cr), and elevated lactate and lipid peaks depending on tumor malignancy. ¹H-MRS demonstrates high sensitivity and specificity in differentiating tumors from non-tumor lesions and provides valuable information for distinguishing gliomas, metastases, meningiomas, abscesses, and lymphomas.

Conclusion. The integration of proton MR spectroscopy with conventional MRI significantly improves the accuracy of differential diagnosis of intracranial lesions and plays an important role in preoperative planning and treatment strategy selection.