Background: Differentiation of brain lesions by conventional MRI alone is not enough.
The introduction of sophisticated imaging methods, such as MR Spectroscopy (MRS), will contribute
to accurate differentiation.
Objective: To determine the diagnostic accuracy of MRS in differentiating neoplasm and non-neoplastic
Methodology: This is a cross-sectional descriptive study conducted at Khartoum State from the period
of 2015 to 2017. Thirty cases with brain lesions were included in the study investigated with
MRS (Single-voxel spectroscopy) and conventional MRI. A comparison of MRS findings and histopathologic
analysis was performed. The ratios of Cho/Cr and Cho/NAA were analyzed and compared
between neoplastic and non-neoplastic brain masses. Data were analyzed using SPSS version
Results: Out of the 30 patients affected with brain lesions, there were 16 females and 14 males
with a mean age of 44 +- 18 years. The ratios of Cho/Cr and Cho/NAA were higher in gliomas, astrocytoma,
and meningioma than non-neoplastic lesions. Kappa statistical value (K) showed a good
agreement between MRS and histopathological analysis (K= 0.60). The diagnostic accuracy of
MRS was 100%, with 82.60% sensitivity, 85.71% specificity, 95% PPV, and 60% NPV.
Conclusion: MRS has high diagnostic accuracy in differentiating neoplasm from non-neoplastic
brain tumors. The elevation ratios of Choline-to- N-acetyl aspartate and choline-to- creatine can
help neurosurgeons and clinicians differentiate benign from malignant masses.