Proton MR Spectroscopy
Date and Location
September 16-18, 2004 - Tübingen, DE
Course Organisers
Milan Hajek
Institute for Clinical and Experimental Medicine
Prague, CZ;
Uwe Klose
Section of Experimental MR of the
Central Nervous System, Department of Neuroradiology
University Hospital of Tübingen, DE
Course venue
Universitätsklinikum Tübingen
Hoppe- Seyler- Str. 3
DE - 72076 Tübingen
Local Organiser
Uwe Klose
Tübingen, DE
Lecturers:
Monika Dezortova, Filip Jiru, Wolfgang Grodd, Milan Hajek, Gunter Helms, Uwe Klose, Jürgen Machann, Irina Mader, Thomas Nägele and others
Localised magnetic resonance spectroscopy (MRS) is an important supplement to magnetic resonance imaging for medical diagnosis in a variety of diseases. MRS is based on the same physical principles but offers unique biochemical information from various organs and tissues and is therefore increasingly applied to improve tissue characterisation in normal and pathological states.While the examination of other nuclei is also possible, the most prominent clinical applications lie in the field of proton MRS and this course will focus mainly on clinical applications of proton MRS. The necessary measurement techniques can be easily established at most whole body MR systems. This course will cover the physical principles, measurement techniques, and the quantification methods of proton MRS. Clinical applications and specific considerations in distinct pathologies will be discussed. Practical demonstrations and examinations at the 1.5 T and 3 T systems of the University Hospital Tübingen are included.
Learning Objectives
Physics and Basic Technique
- The physical and technical basis of spectroscopy
- Chemical shift, spin-spin interaction, j-coupling
- Hardware and software requirements
- Measurement sequences for single voxel spectroscopy
- Principles of volume selection
- Double spine echo sequences, STEAM sequences
- Metabolites in human 1H MRS: biochemistry and in vitro measurements
- Prominent metabolites: NAA, Creatine, Choline, Inositole
- Additional metabolites, metabolic pathways
- Chemical shift imaging: basics and applications
- Principles of CSI, possible sequences and parameters
- Methods of evaluation
- Effects of measurement parameters on in vivo spectra
- Shimming, Pulse optimisation, Long and short echo time spectra
- Safety rules, Quality control
- Quantification of in vivo spectra
- Effects of relaxation times and of inhomogeneities of the B0- and the B1-field
- Comparison of relative and absolute quantification
- Measurement and evaluation of brain macromolecule
- Macromolecules in brain spectra
- Parameterised evaluation of macromolecules and lipids in the brain
- 1H spectroscopy at high field strengths
- Detection of uncoupled and J-coupled spin systems
- 1D and 2D spectroscopy, safety issues and limitations
Clinical Applications
- Brain tumours:
- Tissue characterisation
- Grading of neuronal tumours
- Brain spectroscopy in epilepsy
- Temporal sclerosis and atrophy
- Results of treatment and follow-up
- Brain spectroscopy of inflammatory diseases
- Multiple sclerosis: characterisation of acute and chronic lesions
- Development from acute to chronic stage
- Degenerative brain diseases:
- Amyotrophic lateral sclerosis,
- Kennedy's Syndrome and Cerebellar Atrophy
- Brain spectroscopy in psychiatry
- Neurobiological findings in major psychiatric disorders
- Diagnostic role in dementia
- Effects of pharmacological and non-pharmacological treatment
- Brain spectroscopy in children
- Normal development and metabolic diseases
- Specific changes in NAA, Creatine, Choline
- Hypoxia and Ischemia
- Clinical role of spectroscopy, changes in NAA, lactate
- Spectroscopic imaging vs. single voxel spectroscopy
- Spectroscopy of muscle and bone marrow
- Determination of intra and extra cellular fat in proton spectroscopy
- Lipids in bone marrow
- Spectroscopy of the prostate
- Citrate metabolism, characterization of tumours
- Clinical applications
- Experimental design in MRS
- Selection of volunteers and patients, choice of MRS parameters
- Study design and statistical evaluation
- Evaluation of results by parametric and non-parametric tests
Practical exercise of MR spectroscopy
- Human MRS experiments at 1.5 T
- Human MRS experiments at 3.0 T
- Spectra evaluation with different techniques
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