Rammohan Vadapalli MD, Presenter: Nothing to Disclose

Manas Panigrahi MChir, Abstract Co-Author: Nothing to Disclose

Mandapal Tm MD, Abstract Co-Author: Nothing to Disclose

Abhijeet Roychowdhury MD, Abstract Co-Author: Nothing to Disclose

Pramod Kumar Reddy Kaila MD, Abstract Co-Author: Nothing to Disclose

To assess the role of MRS in the management and Diagnostic Characterization of cord tumors

22 normal age and sex matched controls and 47 patients in the age range of 25 to 67 years with M:F distribution of 3:2 were included in the study. All the patients had undergone Comprehensive Tumor protocol (Localizer,T1 sag,T2 sag,T1 and T2 axial, STIR coronal, Post contrast T1 sag axial coronals) on a 3T Philips Achieva System with a followed by 2D PRESS MRS  single /multi Voxel with following parameters:SIngle Voxel watersuppression,TR 2000 TE 44 Matrix 18x18. . The spectral data for multi voxel were obtained from an 8-mL voxel (2 x 2 x 2 cm 2,000/144; 18 x 18 matrix size; slice thickness, 1 cm; 18 x 18 cm field of view; The MR spectra of IntraSpinal  tumor categories Astrocytomas (15),Ependymomas(n=9),Haemangioblastoma(n=3), Metastases(n=9), Neurogenic tumors(5) Meningiomas (2) neuro enteric cyst(2) ,Epidermoids (n=2) were obtained from Matrix and peritumoral zone as evident on Post contrast sequences. The Spectra were then overlaid on post contrast and T2 image data sets and following Data were Analyzed  

Astrocytomas: Showed Choline elevation with a mean choline creatine ratio of 1.9 reduced NAA.maximum elevations occured at the poles of the tumor>matrix Ependymomas: Elevation of Total Choline was demonstrable in all except for two cases Metastases:showed grossly reduced/absent NAA with Lipid peak elevation  with Minimal elevation of Choline Neurogenic tumors showed Elevation of Total Choline with Lipid resonances neuro enteric cysts showed no choline elevation with Normal NAA. The mean choline creatine ratio was 2.8 Choline/NAA ratio was 1.9 Epidermoids and Neuro enteric cysts showed No choline but a Lipid peak with a small AA peak at 1.2ppm in Neuro enteric cysts Marix choline annd peritumoral Zone Choline ratio was>2 in Ependymomas and Haemangioblastomas, 1.3-1.8 in Metastases with edema, <1 in Astrocytomas. <1> <1> <1> <1>  

Proton MR spectroscopy (Single and Multivoxel) at 3T can be routinely used as a mainstay tool in the Diagnostic characterization and management of  Cord Tumors

  MR spectroscopy adds characterization to MRI morphology of spinal tumors by metabolite ratios in the matrix and both poles of the tumor at cord tumor interfaces .

Vadapalli, R, Panigrahi, M, Tm, M, Roychowdhury, A, Kaila, P, Proton MR Spectroscopy of Spinal Cord Tumors at 3T: Spectrum of MRS Patterns in 45 Cases.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8008453.html