This Article Figures Only Full Text Full Text (PDF) Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Butteriss, D J A Articles by Birchall, D Search for Related Content PubMed PubMed Citation Articles by Butteriss, D J A Articles by Birchall, D

Use of serial proton magnetic resonance spectroscopy to differentiate low grade glioma from tumefactive plaque in a patient with multiple sclerosis

Departments of ¹ Neuroradiology and ² Neuropathology, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE, UK

Correspondence: Dr D Birchall

We report on the use of serial proton MR spectroscopy (¹H MRS) to differentiate between glioma and tumefactive plaque in a known multiple sclerosis (MS) patient who developed a symptomatic cerebral space occupying lesion. Gliomas and acute MS plaques may have indistinguishable chemical resonance spectra, whereas that of chronic plaque is distinct. In our case ¹H MRS demonstrated elevated concentrations of choline, lactate and lipid, with reduced N-acetyl aspartate, a pattern consistent with either low grade glioma or acute demyelinating plaque. A repeat study 4 months later showed no change, this was felt to be incompatible with the natural history of an acute plaque and low grade glioma was diagnosed. Surgical removal of the lesion revealed an oligodendroglioma, confirming the imaging findings.

This article has been cited by other articles:

				J. Dastgir and F. J. DiMario Jr Acute Tumefactive Demyelinating Lesions in a Pediatric Patient With Known Diagnosis of Multiple Sclerosis: Review of the Literature and Treatment Proposal J Child Neurol, April 1, 2009; 24(4): 431 - 437. [Abstract] [PDF]

				C. F. Lucchinetti, R. H. Gavrilova, I. Metz, J. E. Parisi, B. W. Scheithauer, S. Weigand, K. Thomsen, J. Mandrekar, A. Altintas, B. J. Erickson, et al. Clinical and radiographic spectrum of pathologically confirmed tumefactive multiple sclerosis Brain, July 1, 2008; 131(7): 1759 - 1775. [Abstract] [Full Text] [PDF]

				S. M Selkirk and J. Shi Relapsing-remitting tumefactive multiple sclerosis Multiple Sclerosis, December 1, 2005; 11(6): 731 - 734. [Abstract] [PDF]

				C. Enzinger, S. Strasser-Fuchs, S. Ropele, P. Kapeller, R. Kleinert, and F. Fazekas Tumefactive demyelinating lesions: conventional and advanced magnetic resonance imaging Multiple Sclerosis, April 1, 2005; 11(2): 135 - 139. [Abstract] [PDF]

				J H Jaster and T W Smith Demyelination in the brain as a paraneoplastic disorder Br. J. Radiol., October 1, 2004; 77(922): 899 - 899. [Full Text] [PDF]