BEYİN KİTLELERİNDE NEOPLASTİK / NEOPLASTİK OLMAYAN VE YÜKSEK EVRE / DÜŞÜK EVRE AYRIMINDA MR SPEKTROSKOPİNİN YERİ
Amaç: Bu çalışmanın amacı serebral lezyonların ayırıcı tanısında Manyetik Rezonans Spektroskopinin etkinliğini araştırmaktır. Yöntem: Serebral lezyonu olan 46 olgu Manyetik Rezonans Spektroskopi ile incelendi. Kolin, kreatin, Nasetil aspartat ve lipid-laktat pikleri değerlendirildi. Kırk altı olgunun 40'ına stereotaktik biopsi ya da operasyon uygulandı. Histopatolojik sonuçlar ile Manyetik Rezonans Spektroskopi sonuçları karşılaştırıldı. Bulgular: Lezyonların neoplastik/neoplastik olmayan ayrımında Kolin/N-asetil aspartat en yüksek duyarlılığa sahipti (%87.2) ve Kolin/Kreatin, Kolin/N-asetil aspartat, Kolin+Kreatin/N-asetil aspartat oranlarının özgüllük değerleri %100 olarak hesaplandı. Düşük/yüksek evre ayrımında Kolin/Kreatin en yüksek duyarlılığa sahipti (%95.7) ve Kolin/N-asetil aspartat, Kolin+Kreatin/N-asetil aspartat, lipid-laktat oranlarının özgüllüğü %100 olarak hesaplandı. Sonuç olarak Kolin/Kreatin oranının 2.2'den yüksek olması ve eşlik eden lipid-laktat pikinin neoplastik lezyonların düşük/yüksek evre ayrımında %100 (%82.2-100) duyarlılık ve %100 (%71.7-100) özgüllüğe sahip olduğu görüldü. Sonuç: Yüksek Kolin ve düşük N-asetil aspartat piklerinin lezyonların neoplastik/neoplastik olmayan ayrımında etkili olduğu görüldü. Neoplastik lezyonların yüksek/düşük evre ayrımında ise 2.2'den yüksek Kolin/Kreatin oranı ve eşlik eden lipid-laktat pikinin değerli bilgiler verdiği sonucuna varıldı.Anahtar Kelimeler: Beyin neoplazmları, Manyetik rezonans görüntüleme, Manyetik rezonans spektroskopi, Stereotaktik biyopsi
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