MR Spectroscopy is a non-invasive technique that allows the detection and measurement of an array of molecules and metabolites within brain cells. This technique therefore provides information about metabolic processes, neuronal integrity, cell proliferation, cell degeneration and degradation. Its clinical applications are multifaceted and include a long list of conditions such as:

 

Assessment of brain development and maturation: The cause of developmental delay frequently is unknown, and clinicians and families can be frustrated by the lack of imaging correlates, which has serious implications for the selection of therapeutic options and long-term prognosis. MR spectroscopy can reveal patterns of metabolic derangements that may be the result of hypomyelination, decreased numbers of normal neurons, or decreased synaptic density as an underlying cause, which may be missed on routine MR images.

 

Neonatal encephalopathy: Hypoxic-ischemic encephalopathy (HIE), secondary to perinatal asphyxia, is a primary cause of paediatric mortality and morbidity, and results in neurologic outcomes, such as cerebral palsy, mental retardation and epilepsy. Metabolite concentrations, derived from MR spectroscopy measurements, enhance the prognostic accuracy to discriminate among normal/mild, and severe/fatal outcome groups of neonates with encephalopathy.

 

Genetic white matter disorders: Childhood white matter disorders often show similar MR imaging signal-intensity changes, despite different underlying causes. MR spectroscopy aids in classification of leukoencephalopathies (white matter disorders) into groups and helps to narrow the differential diagnosis and thereby direct biochemical and genetic testing.

 

Brain injury: MR spectroscopy provides a non-invasive tool to assess metabolic changes in the brain following head trauma. The observable metabolites are surrogate markers for neuronal density and viability, membrane injury, and hypoxia or ischaemia. The spectral changes have shown to correlate with injury severity and acute changes relate to both neuropsychological deficits and to long-term outcome.


Characterisation and follow-up of brain tumours: MR spectroscopy is an integral tool for evaluation and regular follow-up of brain tumours. High field scanners offer an unrivalled non-invasive assessment of biochemistry of the brain tumours as well as in fundamental and obviating in many cases the need for invasive chirurgical tissue sampling in eloquent brain regions and avoiding adverse effects. During tumour surveillance, MR spectroscopy helps to differentiate in a timely manner tumour recurrence from unspecific treatment-related changes and assist in tailoring the treatment.

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