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MR spectroscopy of 74-year-old with lymphoma

Case Study
Van Cauter, Sofie, M.D. University Hospitals Leuven • Belgium

Patient history

74-year-old presented with visual impairment. The opthalmological examinations were normal.

MR examination

The Achieva 3.0T TX was used.

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Images

 TIW + Gd ADC
TIW + Gd
ADC
74-year-old presented with visual impairment. The opthalmological examinations were normal.
 Cho + NAA + Lipids
Cho + NAA + Lipids


MR of the brain demonstrated a contrast-enhancing lesion in the left occipital lobe. Differential diagnosis is a primary brain tumor (glioblastoma or anaplastic astrocytoma), solitary metastasis or lymphoma. MR Spectroscopy showed extremely elevated choline (indicative for high cellularity), and remarkable lipid peaks (membrane breakdown and necrosis). CRE and NAA are not detectable, there is only an elevated Cho peak and distinct lipids

Diagnosis

These findings are suggestive of an intracranial lymphoma, rather then a high grade primary tumor or a metastasis. This is of particular interest, as three entities require different therapeutic strategies.

Clinical impact of fast 3.0T MR spectroscopy

Applying SENSE in two directions has allowed the Leuven team to dramatically shorten the scan time of MR spectroscopic imaging (MRSI) in the brain to about three and a half minutes without loss of spectral or spatial resolution, while maintaining sufficient SNR. These shorter scan times make it practical to include MR spectroscopy in routine brain MR exams.



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Sep 20, 2011

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Case Study
Achieva 3.0T
lymphoma, Spectroscopy
 

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