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LETTER TO THE EDITOR  
Year : 2018  |  Volume : 28  |  Issue : 4  |  Page : 481
Role of proton MR spectroscopy in spinal cord lesions: A guarded espousal


Department of Radiodiagnosis, Teerthanker Mahaveer Medical College & Research Center, Teerthanker Mahaveer University, Moradabad, UP, India

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Date of Web Publication18-Dec-2018
 

How to cite this article:
Agarwal A. Role of proton MR spectroscopy in spinal cord lesions: A guarded espousal. Indian J Radiol Imaging 2018;28:481

How to cite this URL:
Agarwal A. Role of proton MR spectroscopy in spinal cord lesions: A guarded espousal. Indian J Radiol Imaging [serial online] 2018 [cited 2019 May 24];28:481. Available from: http://www.ijri.org/text.asp?2018/28/4/481/247770


Sir,

I read with great interest the article titled “3T proton MR spectroscopy evaluation of spinal cord lesions” by Sathyanathan et al. published in the July–September, 2018 issue of the Indian Journal of Radiology and Imaging.[1] The manuscript is well written and informative. The authors have narrated the MR spectroscopy (MRS) protocol and patterns in various intramedullary spinal lesions in a very efficient manner. However, I would like to make the following contributions and observations pertinent to the study.

In their study cohort of 50 patients, the authors have investigated spectral pattern on intramedullary spinal cord lesions. They designated four of them as schwannoma, which is an extramedullary lesion. Literature shows very few case reports of intramedullary schwannoma, which may be found in neurofibromatosis.[2],[3] Even in the subsequent discussion, the MRS pattern of these lesions is not elaborated. So, it will be of great help if authors could clarify my doubts in this regard.

The present study[1] defines the changes in the metabolites in different spinal lesions based on the deviation in their peak values from the normal spectra. In the previous few studies,[4],[5] the results have been expressed in terms of metabolite ratios, which is an absolute quantification method. Therefore, I would like to know about the authors' experience in evaluating the metabolite ratios and their feasibility pertaining to the study.

High signal-to-noise ratio is addressed in the present study[1] by the use of high magnetic field strength (3 T). However, there are spectral reliability indices such as Cramér–Rao lower bounds of each metabolite, mean, and standard deviation of the spectral line width, the coefficient of variations of the measurements, and the group average of the spectra.[5] These quality indicators can be used in future studies for enhancing the spectral quality and dependability.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Sathyanathan BP, Raju BP, Natarajan K, Ranganathan R. 3T proton MR spectroscopy evaluation of spinal cord lesions. Indian J Radiol Imaging 2018;28:285-95.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Koeller KK, Rosenblum RS, Morrison AL. Neoplasms of the spinal cord and filum terminale: Radiologic-pathologic correlation. Radiographics 2000;20:1721-49.  Back to cited text no. 2
    
3.
Nayak R, Chaudhuri A, Chattopadhyay A, Ghosh SN. Thoracic intramedullary schwannoma: A case report and review of literature. Asian J Neurosurg 2015;10:126-8.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Marliani AF, Clementi V, Albini-Riccioli L, Agati R, Carpenzano M, Salvi F, et al. Quantitative cervical spinal cord 3T proton MR spectroscopy in multiple sclerosis. AJNR Am J Neuroradiol 2010;31:180-8.  Back to cited text no. 4
    
5.
Hock A, Henning A, Boesiger P, Kollias SS. 1H-MR spectroscopy in the human spinal cord. Am J Neuroradiol 2013;34:1682-9.  Back to cited text no. 5
    

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Correspondence Address:
Arjit Agarwal
Department of Radiodiagnosis, Teerthanker Mahaveer Medical College & Research Center, Teerthanker Mahaveer University, Moradabad, UP
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijri.IJRI_401_18

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