SPECTROSCOPY AND 3D-CISS SEQUENCE IN CYSTIC LESIONS OF BRAIN: A PROSPECTIVE EVALUATION ON MRI

BACKGROUND The present study was undertaken to differentiate between benign and malignant cystic lesions of the brain and to establish a diagnosis on MRI. To study the role of MR spectroscopy and 3D CISS in the evaluation of various cystic lesions in the brain wherever applicable. METHODS The study was conducted on 35 patients at Assam Medical College and Hospital, Dibrugarh, with a suspicion of bra in SOLs by neurologists, paediatricians and physicians from in and around Dibrugarh over a period of one year from January 2011 to December 2012. Out of the 35 patients who were evaluated, Arachnoid cyst (20%) was the most common non-neoplastic cystic lesion, Craniopharyngioma (5.7%) was the most common benign neoplastic cystic lesion and Glioma (17.1%) was the most common malignant neoplastic cystic lesion. In the present study, conventional MRI with additional techniques like MRS and 3D CISS together were found to be accurate in 94.28% of cases. One case of MRI diagnosis of low-grade glioma came out to be high-grade on HPE. One case of MRI diagnosis of cystic astrocytoma came out to be a benign vascular lesion-Haemangioma on HPE. CONCLUSION MRI is the most sensitive modality in the characterisation of intracranial cystic lesions. MRS is a complementary to conventional MRI in diagnosing the cystic lesions of the brain and influencing the overall management of these lesions; 3D-CISS sequence is superior and more accurate than routine SE sequences in the diagnosis of intraventricular cystic lesions.