MR spectroscopy differences between lipomatosis of nerve and neuromuscular choristoma: a potential adjunctive diagnostic tool

• Published in: Skeletal radiology 2020-12, Vol.49 (12), p.2051-2057
• Main Authors: Marek, T., Amrami, K. K., Spinner, R. J., Port, J. D.
• Format: Article
• Language: English
• Subjects: Biopsy; Composition; Diagnostic imaging; Diagnostic software; Diagnostic systems; Fatty acids; Glycerin; Glycerol; Imaging; Lipid composition; Lipids; Lipomatosis; Magnetic resonance imaging; Magnetic resonance spectroscopy; Medical diagnosis; Medical imaging equipment; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Moisture content; Nuclear Medicine; Orthopedics; Pathology; Radiology; Spectrum analysis; Tumors; Unsaturated fatty acids; Water content
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-020-03479-9

Objective To describe differences between lipomatosis of nerve (LN) and neuromuscular choristoma (NMC) evaluated with MR spectroscopy (MRS). Materials and methods Eight patients were included in this prospective pilot study: three patients with LNs and five with NMCs. Single voxel PRESS MRS of the tumors were acquired with 3 T MRI. MRS data were processed with LCModel version 6.3-1J using the internal “lipid-8” basis set. From individual lipid peak and water content measurements, total fatty acid molecules (TFAM), unsaturated fatty acid molecules (UFAM), and glycerol molecules (GM) were computed and analyzed, as well as ratios of UFAM/TFAM, TFAM/GM, and a fatty-acid chain-length index (CLI). Results The LN group included two men and one woman (average age 58.3 years); the NMC group included two men and three women (average age 20.4 years). Lipid composition analysis showed that LN had considerably more fat than NMC: TFAM: LN = 15.29 vs NMC = 7.14; UFAM: LN = 4.48 vs NMC = 2.63; GM: LN = 5.20 vs NMC = 1.02. Both tumors had a similar fraction of unsaturated fatty acids: UFAM/TFAM: LN = 0.29 vs NMC = 0.37. LN had the usual number of FA molecules/glycerol molecule, while NMC had considerably more: TFAM/GM: LN = 2.94 vs NMC = 6.98. Finally, average FA chains were longer in NMC: CLI: LN = 17.39 vs NMC = 22.55. Conclusion Our analysis suggests measurable differences in the amount and composition of lipid in LN and NMC. While a larger, statistically powered study is needed, these initial findings may be helpful to properly diagnose ambiguous cases and thereby avoid surgical intervention such as biopsy.