Localized proton spectroscopy of focal brain pathology in humans: Significant effects of edema on spin–spin relaxation time

Localized proton nuclear magnetic resonance (NMR) spectroscopy of human brain in two common focal pathologies producing brain edema (peritumor edema and acute edema–tous ischemic stroke) was performed utilizing point resolved spectroscopy (PRESS). The spectra obtained from the pathological tissues were characterized by a reduced N‐acetyl‐as–partate (NAA) to total creatine (Cr) ratio (NAA/Cr) and high level of lactate. While the spin lattice relaxation time (T1) of the main metabolite resonances, namely, those of NAA, Cr, and choline containing compounds (Cho), showed values similar to those of normal brain, the spin‐spin relaxation time (T2) of these metabolites exhibited a dramatic shortening in pathological tissues. Serial postoperative measurements of T2 in two patients with peritumor edema showed a gradual recovery of the T2 shortening corresponding to improvement of the edema. The majority of localized spectroscopy studies in humans is performed using a sequence which utilizes spin echo signals with a fixed single echo time. Hence, the signal intensities of the metabolite resonances obtained are inherently T2 dependent. The current study underscores that cautious interpretation of clinical data with respect to metabolite quantification is warranted.