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Recurrent high-grade astrocytoma

Kang PK - MedPix (2007)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Recurrent high-grade astrocytoma

History: 38 y.o. white male with previously diagnosed high-grade glioma in the left parietal lobe, s/p radiation treatment.

Findings: Initial multiple MR images demonstrate a ring-enhancing lesion in the site of glioma, previously treated with radiation therapy, with some areas of nodular changes. MR spectroscopy of normal site, TE = 144 msec, which demonstrates prominent N-acetylaspartate (NAA) peak at the 2.0 ppm, which is the normal neuronal marker. Creatine peak at 3.0 ppm and choline peak at 3.2 ppm are also demonstrated, showing normal relationships. MR spectroscopy of the abnormal site, TE = 144 msec, which demonstrates elevation of the choline peak, and the suppression of the NAA peak, along with an inverted peak at the 1.0-1.2 ppm, which is the lactate peak (which characteristically inverts at TE = 144 msec). These findings suggest tumor recurrence with some areas of necrosis, rather than radiation-induced changes.

Ddx: • Residual tumor • Recurrent tumor • Radiation effect • Normal brain • Post-operative changes

Dxhow: MR Spectroscopy

Exam: N/C

No MeSH data available.


MR spectroscopy of the contralateral normal side, TE = 144 msec, that demonstrates prominent N-acetylaspartate (NAA) peak at the 2.0 ppm, which is the normal neuronal marker.  Creatine peak at 3.0 ppm and choline peak at 3.2 ppm are also demonstrated, showing normal relationships.
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MPX1694_synpic18252: MR spectroscopy of the contralateral normal side, TE = 144 msec, that demonstrates prominent N-acetylaspartate (NAA) peak at the 2.0 ppm, which is the normal neuronal marker. Creatine peak at 3.0 ppm and choline peak at 3.2 ppm are also demonstrated, showing normal relationships.


Recurrent high-grade astrocytoma

Kang PK - MedPix (2007)

MR spectroscopy of the contralateral normal side, TE = 144 msec, that demonstrates prominent N-acetylaspartate (NAA) peak at the 2.0 ppm, which is the normal neuronal marker.  Creatine peak at 3.0 ppm and choline peak at 3.2 ppm are also demonstrated, showing normal relationships.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1694&req=5

MPX1694_synpic18252: MR spectroscopy of the contralateral normal side, TE = 144 msec, that demonstrates prominent N-acetylaspartate (NAA) peak at the 2.0 ppm, which is the normal neuronal marker. Creatine peak at 3.0 ppm and choline peak at 3.2 ppm are also demonstrated, showing normal relationships.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Recurrent high-grade astrocytoma

History: 38 y.o. white male with previously diagnosed high-grade glioma in the left parietal lobe, s/p radiation treatment.

Findings: Initial multiple MR images demonstrate a ring-enhancing lesion in the site of glioma, previously treated with radiation therapy, with some areas of nodular changes. MR spectroscopy of normal site, TE = 144 msec, which demonstrates prominent N-acetylaspartate (NAA) peak at the 2.0 ppm, which is the normal neuronal marker. Creatine peak at 3.0 ppm and choline peak at 3.2 ppm are also demonstrated, showing normal relationships. MR spectroscopy of the abnormal site, TE = 144 msec, which demonstrates elevation of the choline peak, and the suppression of the NAA peak, along with an inverted peak at the 1.0-1.2 ppm, which is the lactate peak (which characteristically inverts at TE = 144 msec). These findings suggest tumor recurrence with some areas of necrosis, rather than radiation-induced changes.

Ddx: • Residual tumor • Recurrent tumor • Radiation effect • Normal brain • Post-operative changes

Dxhow: MR Spectroscopy

Exam: N/C

No MeSH data available.