RESUMO
This study aims at evaluating the application of magnetic resonance spectroscopy (MRS) in the differential diagnosis of brain tumors and inflammatory brain lesions. The examinations of 81 individuals, who performed brain MRS and were retrospectively analyzed. The patients with ages between 10 and 80 years old, were divided into two groups. Group A consisted of 42 individuals with diagnoses of cerebral toxoplasmosis and Group B was formed of 39 individuals with diagnosis of glial neoplasms. On analyzing the ROC curve, the discriminatory boundary for the Cho/Cr ratio between inflammatory lesions and tumors was 1.97 and for the NAA/Cr ratio it was 1.12. RMS is an important method useful in the distinction of inflammatory brain lesions and high-degree tumors when the Cho/Cr ratio is greater than 1.97 and the NAA/Cr ratio is less than 1.12. And so this method is important in the planning of treatment and monitoring of the therapeutic efficiency.
Assuntos
Neoplasias Encefálicas/diagnóstico , Glioma/diagnóstico , Espectroscopia de Ressonância Magnética , Toxoplasmose Cerebral/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto JovemRESUMO
This study aims at evaluating the application of magnetic resonance spectroscopy (MRS) in the differential diagnosis of brain tumors and inflammatory brain lesions. The examinations of 81 individuals, who performed brain MRS and were retrospectively analyzed. The patients with ages between 10 and 80 years old, were divided into two groups. Group A consisted of 42 individuals with diagnoses of cerebral toxoplasmosis and Group B was formed of 39 individuals with diagnosis of glial neoplasms. On analyzing the ROC curve, the discriminatory boundary for the Cho/Cr ratio between inflammatory lesions and tumors was 1.97 and for the NAA/Cr ratio it was 1.12. RMS is an important method useful in the distinction of inflammatory brain lesions and high-degree tumors when the Cho/Cr ratio is greater than 1.97 and the NAA/Cr ratio is less than 1.12. And so this method is important in the planning of treatment and monitoring of the therapeutic efficiency.
O presente estudo tem como objetivo avaliar a aplicação da espectroscopia por ressonância magnética (ERM) no diagnóstico diferencial entre lesões expansivas encefálicas inflamatórias e neoplásicas. Foram analisados retrospectivamente 81 indivíduos que realizaram exames de ERM com idade entre 10 a 18 anos, divididos em dois grupos. O grupo A foi formado por 42 indivíduos com diagnóstico de neurotoxoplasmose e o grupo B foi formado por 39 indivíduos com diagnóstico de neoplasias gliais. Após análise da curva ROC observou-se que o valor discriminatório da relação Co/Cr entre lesões inflamatórias e neoplásicas foi de 1,97 e da relação Naa/Cr foi de 1,12. A espectroscopia por RM é um método útil na distinção de lesões expansivas inflamatórias e neoplasias de alto grau quando a relação Co/Cr é maior que 1,97 e a relação Naa/Cr é menor que 1,12, o que torna este método importante no planejamento do tratamento e monitorização da eficácia terapêutica.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Neoplasias Encefálicas/diagnóstico , Glioma/diagnóstico , Espectroscopia de Ressonância Magnética , Toxoplasmose Cerebral/diagnóstico , Diagnóstico Diferencial , Estadiamento de Neoplasias , Estudos Retrospectivos , Curva ROC , Sensibilidade e Especificidade , Adulto JovemRESUMO
BACKGROUND: Lesions of the brain denominated as unidentified bright objects (UBOs), which are not included in the diagnostic criteria for neurofibromatosis type 1 (NF1) established by the National Institutes of Health (NIH), have been detected by MRI. OBJECTIVE: The purpose of this study was to investigate the possibility of including the presence of UBOs as a diagnostic criterion for NF1 in children. MATERIALS AND METHODS: The study included 88 children between the ages of 2 and 18 years. The case group consisted of 40 children diagnosed with sporadic or familial NF1 according to the criteria established by the NIH. A control group consisted of 48 individuals referred for routine MRI of the brain for other complaints not related to NF1. RESULTS: UBOs were identified in 70% of the NF1 patients and in none of the control group. The sensitivity of the presence of UBOs for the diagnosis of NF1 was 70% (CI 53-83%), with a false-negative rate of 30% (CI 27-47%), a specificity of 100% (CI 86-100%) and a false-positive rate of 0% (CI 0-14%). CONCLUSION: Faced with the difficulties in diagnosing NF1 in children and the high frequency and specificity of the presence UBOs identified by MRI in our series, we recommend the inclusion of the presence UBOs as a diagnostic criterion for NF1 in children.
