Fig. 1
From: Magnetic resonance spectroscopy in pediatric brain tumors: how to make a more confident diagnosis
A 12-year-old male patient presented with headache. a, b Axial and coronal T2WI show a heterogenous hyper intense left cerebellar and vermian SOL with mixed solid and cystic components. c 2D PRESS 144 ms echo spectrum shows mild elevation of choline peak and nearly normal Cr and NAA. The Cho/Cr ratio = 2, Cho/NAA ratio = 0.5, Cho/NAA+Cr ratio = 1.2, NAA/Cho ratio = 2, and NAA/Cr ratio = 4.1 with inverted lactate peak. d 2D short TE 26 ms echo spectrum shows additional equivocal myo-inositol peak (mI/Cr ratio = 0.72) and a lipid peak. MRS diagnosis: primary low-grade astrocytoma. Histopathologically proved: WHO grade I cystic astrocytoma