Abstract
OBJECTIVES: Intracranial tuberculomas are one of the common causes of space-occupying lesions of the brain in developing countries. Proton ((1)H) magnetic resonance spectroscopy (MRS) has shown lipid peak in intracranial tuberculomas as a characteristic feature. Phosphorus ((31)P) MRS has been used to evaluate intracranial lesions and to calculate tissue pH non-invasively. The aim of this study is to evaluate intracranial tuberculomas using (31)PMRS. MATERIALS AND METHODS: Intracranial tuberculomas proven by stereotactic or surgical biopsy were included in the study. After routine T1- and T2-weighted sequences, (31)P MRS was performed using single-voxel intravoxel in vivo spectroscopy (ISIS) technique in the central core of the tuberculoma (voxel size 1-2 mm(3)). The pH was estimated using Petroff 's method using the chemical shift between phosphocreatine and Pi. RESULTS: (31)P MRS was available for 26 patients, in which there was significant positive correlation between high-energy phosphate metabolites, (markers of bioenergetic status), and low-energy phosphate metabolites (membrane phospholipids and inorganic phosphate). The calculated pH was slightly alkaline and varied from 6.97 to 7.22. CONCLUSION: Intracranial tuberculomas showed alkaline pH in (31)P MRS and this may be useful in the characterization of these lesions and possibly also in their treatment.