Skip to main content
Log in

New observations concerning the interpretation of magnetic resonance spectroscopy of meningioma

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

This study was aimed to clarify some ambiguities in the interpretation of proton magnetic resonance spectroscopy (1H-MRS) of meningiomas. The cases of 31 meningioma patients (27 benign and 4 nonbenign meningiomas) that underwent single-voxel 1H-MRS (PRESS sequence, TR/TE = 2,000 ms/68, 136, 272 ms) were retrospectively analyzed. To verify the findings of in-vivo study, phantoms were measured, and pathological sections of 11 patients were reviewed. All meningiomas demonstrated increased choline and decreased creatine, except for a lipomatous meningioma that only displayed a prominent lipid (Lip) peak. Alanine (Ala) and lactate (Lac) coexisted in eight cases, indicating an alternative pathway of energy metabolism in meningiomas. They partially overlapped with each other and demonstrated a triplet-like spectral pattern, which was consistent with phantom study. Glutamine/glutamate (Glx) was helpful for the recognition of meningioma when Ala was absent. N-acetyl compounds(NACs) were observed in nine cases whose voxels were completely limited within the tumors, indicating that meningiomas might have endogenous NACs. Lac was indicative of an aggressive meningioma, although not always a nonbenign one. Lip not only represented micronecrosis in nonbenign meningiomas, but also reflected microcystic changes or fatty degeneration in benign meningiomas. 1H-MRS reflects some distinctive biochemical and pathological changes of meningiomas that might be misinterpreted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Claus EB, Bondy ML, Schildkraut JM et al (2005) Epidemiology of intracranial meningioma. Neurosurgery 57:1088–1095

    Article  PubMed  Google Scholar 

  2. Demir MK, Iplikcioglu AC, Dincer A et al (2006) Single voxel proton MR spectroscopy findings of typical and atypical intracranial meningiomas. Eur J Radiol 60:48–55

    Article  PubMed  Google Scholar 

  3. Cho YD, Choi GH, Lee SP et al (2003) (1)H-MRS metabolic patterns for distinguishing between meningiomas and other brain tumors. Magn Reson Imaging 21:663–672

    Article  PubMed  Google Scholar 

  4. Shino A, Nakasu S, Matsuda M et al (1999) Noninvasive evaluation of the malignant potential of intracranial meningiomas performed using proton magnetic resonance spectroscopy. J Neurosurg 91:928–934

    PubMed  CAS  Google Scholar 

  5. Buhl R, Nabavi A, Wolff S et al (2007) MR spectroscopy in patients with intracranial meningiomas. Neurol Res 29:43–46

    Article  PubMed  CAS  Google Scholar 

  6. Majós C, Alonso J, Aguilera C et al (2003) Utility of proton MR spectroscopy in the diagnosis of radiologically atypical intracranial meningiomas. Neuroradiology 45:129–136

    PubMed  Google Scholar 

  7. Kinoshita Y, Yokota A (1997) Absolute concentrations of metabolites in human brain tumors using in vitro proton magnetic resonance spectroscopy. NMR Biomed 10:2–12

    Article  PubMed  CAS  Google Scholar 

  8. Lehnhardt FG, Rohn G, Ernestus RI et al (2001) 1H- and (31)P-MR spectroscopy of primary and recurrent human brain tumors in vitro: malignancy-characteristic profiles of water soluble and lipophilic spectral components. NMR Biomed 14:307–317

    Article  PubMed  CAS  Google Scholar 

  9. Howe FA, Barton SJ, Cudlip SA et al (2003) Metabolic profiles of human brain tumors using quantitative in vivo 1H magnetic resonance spectroscopy. Magn Reson Med 49:223–232

    Article  PubMed  CAS  Google Scholar 

  10. Castillo M, Kwock L, Mukherji SK (1996) Clinical applications of proton MR spectroscopy. AJNR Am J Neuroradiol 17:1–15

    PubMed  CAS  Google Scholar 

  11. Negendank WG, Sauter R, Brown TR et al (1996) Proton magnetic resonance spectroscopy in patients with glial tumors: a multicenter study. J Neurosurg 84:449–458

    PubMed  CAS  Google Scholar 

  12. Lehnhardt FG, Bock C, Rohn G et al (2005) Metabolic differences between primary and recurrent human brain tumors: a 1H NMR spectroscopic investigation. NMR Biomed 18:371–382

    Article  PubMed  CAS  Google Scholar 

  13. Ryner LN, Sorenson JA, Thomas MA (1995) Localized 2D J-resolved 1H MR spectroscopy: strong coupling effects in vitro and in vivo. Magn Reson Imaging 13:853–869

    Article  PubMed  CAS  Google Scholar 

  14. Alvarez F, Roda JM, Perez Romero M et al (1987) Malignant and atypical meningiomas: a reappraisal of clinical, histological, and computed tomographic features. Neurosurgery 20:688–694

    Article  PubMed  CAS  Google Scholar 

  15. New PF, Hesselink JR, O’Carroll CP et al (1982) Malignant meningiomas: CT and histologic criteria, including a new CT sign. AJNR Am J Neuroradiol 3:267–276

    PubMed  CAS  Google Scholar 

  16. Falini A, Calabrese G, Origgi D et al (1996) Proton magnetic resonance spectroscopy and intracranial tumours: clinical perspectives. J Neurol 243:706–714

    Article  PubMed  CAS  Google Scholar 

  17. Hazany S, Hesselink JR, Healy JF et al (2007) Utilization of glutamate/creatine ratios for proton spectroscopic diagnosis of meningiomas. Neuroradiology 49:121–127

    Article  PubMed  Google Scholar 

  18. Manton DJ, Lowry M, Blackband SJ et al (1994) Quantitative proton MRS of brain tumors reveals increased cholineT2 in meningiomas. MAGMA 2:361–363

    Article  CAS  Google Scholar 

  19. Harting I, Jost G, Hacke N et al (2005) Magnetic resonance spectroscopy of brain tumours. Nervenarzt 76:403–417

    Article  PubMed  CAS  Google Scholar 

  20. Poptani H, Gupta RK, Jain VK et al (1995) Cystic intracranial mass lesions: possible role of in vivo MR spectroscopy in its differential diagnosis. Magn Reson Imaging 13:1019–1029

    Article  PubMed  CAS  Google Scholar 

  21. Akutsu H, Matsumura A, Isobe T et al (2002) Chronological change of brain abscess in (1)H magnetic resonance spectroscopy. Neuroradiology 44:574–578

    Article  PubMed  CAS  Google Scholar 

  22. Christiansen P, Henriksen O, Stubgaard M et al (1993) In vivo quantification of brain metabolites by 1H-MRS using water as an internal standard. Magn Reson Imaging 11:107–118

    Article  PubMed  CAS  Google Scholar 

  23. Majós C, Alonso J, Aguilera C et al (2003) Proton magnetic resonance spectroscopy ((1)H MRS) of human brain tumours: assessment of differences between tumour types and its applicability in brain tumour categorization. Eur Radiol 13:582–591

    PubMed  Google Scholar 

  24. Miller BL (1991) A review of chemical issues in 1H NMR spectroscopy: N-acetyl-L-aspartate, creatine and choline. NMR Biomed 4:47–52

    Article  PubMed  CAS  Google Scholar 

  25. Bruhn H, Frahm J, Gyngell ML et al (1989) Noninvasive differentiation of tumors with use of localized H-1 MR spectroscopy in vivo: initial experience in patients with cerebral tumors. Radiology 172:541–548

    PubMed  CAS  Google Scholar 

  26. Barba I, Moreno A, Martinez-Perez I et al (2001) Magnetic resonance spectroscopy of brain hemangiopericytomas: high myoinositol concentrations and discrimination from meningiomas. J Neurosurg 94:55–60

    Article  PubMed  CAS  Google Scholar 

  27. Kinoshita Y, Kajiwara H, Yokota A et al (1994) Proton magnetic resonance spectroscopy of brain tumors: an in vitro study. Neurosurgery 35:606–613

    Article  PubMed  CAS  Google Scholar 

  28. Kugel H, Heindel W, Ernestus RI et al (1992) Human brain tumors: spectral patterns detected with localized H-1 MR spectroscopy. Radiology 183:701–709

    PubMed  CAS  Google Scholar 

  29. Holowenko D, Peeling J, Sutherland G (1992) 1H NMR properties of N-acetylaspartylglutamate in extracts of nervous tissue of the rat. NMR Biomed 5:43–47

    Article  PubMed  CAS  Google Scholar 

  30. Gadian DG, Bates TE, Williams SR et al (1991) Approaches to editing, assignment and interpretation of proton spectra. NMR Biomed 4:85–89

    Article  PubMed  CAS  Google Scholar 

  31. Usenius JP, Kauppinen RA, Vainio PA et al (1994) Quantitative metabolite patterns of human brain tumors: detection by 1H NMR spectroscopy in vivo and in vitro. J Comput Assist Tomogr 18:705–713

    Article  PubMed  CAS  Google Scholar 

  32. Ott D, Hennig J, Ernst T (1993) Human brain tumors: assessment with in vivo proton MR spectroscopy. Radiology 186:745–752

    PubMed  CAS  Google Scholar 

  33. Opstad KS, Provencher SW, Bell BA et al (2003) Detection of elevated glutathione in meningiomas by quantitative in vivo 1H MRS. Magn Reson Med 49:632–637

    Article  PubMed  CAS  Google Scholar 

  34. Roda JM, Pascual JM, Carceller F et al (2000) Nonhistological diagnosis of human cerebral tumors by 1H magnetic resonance spectroscopy and amino acid analysis. Clin Cancer Res 6:3983–3993

    PubMed  CAS  Google Scholar 

  35. Cheng LL, Ma MJ, Becerra L et al (1997) Quantitative neuropathology by high resolution magic angle spinning proton magnetic resonance spectroscopy. Proc Natl Acad Sci USA 94:6408–6413

    Article  PubMed  CAS  Google Scholar 

  36. Pfisterer WK, Hendricks WP, Scheck AC et al (2007) Fluorescent in situ hybridization and ex vivo 1H magnetic resonance spectroscopic examinations of meningioma tumor tissue: is it possible to identify a clinically-aggressive subset of benign meningiomas? Neurosurgery 61:1048–1059

    PubMed  Google Scholar 

  37. Cerda-Nicolas M, Lopez-Gines C, Perez-Bacete M et al (2000) Histopathological and cytogenetic findings in benign, atypical and anaplastic human meningiomas: a study of 60 tumors. J Neurooncol 47:99–108

    Article  PubMed  CAS  Google Scholar 

  38. Schober R, Himuro H, Wechsler W (1988) Cystic changes and vascular permeability in meningiomas. Clin Neuropathol 7:16–21

    PubMed  CAS  Google Scholar 

  39. Roncaroli F, Scheithauer BW, Laeng RH et al (2001) Lipomatous meningioma: a clinicopathologic study of 18 cases with special reference to the issue of metaplasia. Am J Surg Pathol 25:769–775

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

We acknowledge Ms. Tsukada for her assistance in the pathological studies.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Akira Matsumura.

Additional information

Grant: This study was supported by the Japan-China Sasakawa Medical Fellowship (Nippon Foundation, Japan)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yue, Q., Isobe, T., Shibata, Y. et al. New observations concerning the interpretation of magnetic resonance spectroscopy of meningioma. Eur Radiol 18, 2901–2911 (2008). https://doi.org/10.1007/s00330-008-1079-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-008-1079-6

Keywords

Navigation