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Brain MR Spectroscopy (MRS)

Advanced functional MRI technique providing in-vivo metabolic information about brain tissue useful in tumor characterization, epilepsy and metabolic disorders.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Radyoloji department. Book Appointment →

What is Brain MR Spectroscopy (MRS)?

Magnetic resonance spectroscopy (MRS) is a quantitative MR technique that detects chemical signals from metabolites within a defined voxel of brain tissue. Single-voxel spectroscopy (SVS) and chemical shift imaging (CSI/multivoxel) are the main techniques, performed at 1.5T or 3T with PRESS (Point Resolved Spectroscopy) or STEAM (Stimulated Echo Acquisition Mode) sequences.

Key metabolites and clinical relevance: N-acetylaspartate (NAA, neuronal marker, decreased in neuronal loss), choline (Cho, cell membrane turnover, elevated in tumors and demyelination), creatine (Cr, energy metabolism, used as internal reference), lactate (Lac, anaerobic metabolism, indicates necrosis or hypoxia), lipids (necrosis), myo-inositol (mI, glial marker, elevated in Alzheimer's), and glutamate-glutamine (Glx, excitatory neurotransmitter).

Clinical applications include differentiation of low-grade vs high-grade glioma (Cho/NAA ratio >2 suggests high-grade), tumor recurrence vs radiation necrosis post-treatment, characterization of ring-enhancing lesions (abscess vs tumor), epilepsy lateralization (decreased NAA in seizure focus), neurodegenerative disease monitoring (Alzheimer, Parkinson), and inborn errors of metabolism (mitochondrial diseases, leukodystrophies).

Symptoms

Test, not a disease — clinical indications:
Brain tumor characterization (grading, type)
Tumor recurrence vs radiation necrosis
Ring-enhancing brain lesion differential
Epilepsy presurgical evaluation and lateralization
Neurodegenerative disease assessment
Suspected mitochondrial or metabolic disease
Demyelinating disease characterization

Risk Factors

Patient factors limiting study quality:
Inability to remain still during 5-15 minute acquisition
Severe claustrophobia
MR-incompatible implants (older pacemakers, aneurysm clips)
Recent surgery with hemosiderin or air
Lesion close to bone or air-filled structures
Susceptibility artifacts (hemorrhage, calcification)
Pediatric patient requiring sedation

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Newly diagnosed brain tumor for grading
  • Suspected tumor recurrence post-radiation
  • Atypical ring-enhancing lesion on conventional MRI
  • Refractory epilepsy presurgical evaluation
  • Suspected neurodegenerative or metabolic disease
  • Pediatric patient with developmental delay
  • Inborn error of metabolism workup
  • Treatment response monitoring in glioma

Treatment Methods

01
Single-voxel or multivoxel acquisition based on indication
02
PRESS or STEAM sequence with appropriate echo times
03
Voxel placement to maximize lesion content and minimize artifacts
04
Spectrum analysis with peak identification and quantification
05
Comparison with normal contralateral region when feasible
06
Integration with conventional MRI, perfusion and diffusion
07
LCModel or similar software for metabolite quantification
08
Multidisciplinary correlation with clinical and pathological findings

Which Department to Visit?

You can visit our Radyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.