Diagnostic value of proton MR spectroscopy and diffusion-weighted MR imaging in childhood inherited neurometabolic brain diseases and review of the literature.

Abstract	The purpose of this study is to evaluate parenchymal diffusion properties and metabolite ratios in affected brain tissues of inherited neurometabolic brain diseases with an overview of the current literature about the diagnostic data of both techniques in childhood inherited metabolic brain diseases. The study group was consisting, 19 patients (15 males, 4 females; mean age, 54 months (4.5 years); age range, 1-171 months (14.25 years)) diagnosed with inherited neurometabolic brain disease. Single- and multivoxel proton MRS was carried out and NAA/Cr, Cho/Cr, mI/Cr, Glx/Cr ratios were calculated. Presence of lactate peak and abnormal different peaks were noted. ADC values were calculated from brain lesions. Results are compared with age and sex matched normal subjects. Elevated NAA/Cr ratio (Canavan disease), galactitol peak (galactosemia) at 3.7 ppm, branched chain amino acids (Maple syrup urine disease-MSUD) at 0.9 ppm were seen on different diseases. In Leigh disease and MSUD restricted diffusion was detected. Different diffusion properties were seen only in one Glutaric aciduria lesions. NAA/Cr ratios and calculated ADC values were significantly different from normal subjects (p<0.05). DWI combined with MRS are complementary methods to routine cranial MRI for evaluating neurometabolic diseases which can give detailed information about neurochemistry of affected brain areas.
Authors	Handan Cakmakci, Yeliz Pekcevik, Uluc Yis, Aycan Unalp, Semra Kurul
Journal	European journal of radiology (Eur J Radiol) Vol. 74 Issue 3 Pg. e161-71 (Jun 2010) ISSN: 1872-7727 [Electronic] Ireland
PMID	19540689 (Publication Type: Journal Article, Review)
Copyright	Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.
Chemical References	Biomarkers Protons
Topics	Adolescent Biomarkers (analysis) Brain Diseases, Metabolic, Inborn (diagnosis, metabolism) Child Child, Preschool Diffusion Magnetic Resonance Imaging (methods) Female Humans Infant Infant, Newborn Magnetic Resonance Spectroscopy (methods) Male Protons Reproducibility of Results Sensitivity and Specificity

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