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

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Abstract

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.

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Acknowledgments

The authors wish to thank Mandie Maroney for her assistance managing the MRS and imaging data for this study.

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Authors and Affiliations

  1. Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA

    T. Marek & R. J. Spinner

  2. Department of Radiology, Mayo Clinic, Mayo E2-31, 200 First Street SW, Rochester, MN, USA

    K. K. Amrami & J. D. Port

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  1. T. Marek
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  2. K. K. Amrami
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  3. R. J. Spinner
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  4. J. D. Port
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Correspondence to J. D. Port.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Marek, T., Amrami, K.K., Spinner, R.J. et al. MR spectroscopy differences between lipomatosis of nerve and neuromuscular choristoma: a potential adjunctive diagnostic tool. Skeletal Radiol 49, 2051–2057 (2020). https://doi.org/10.1007/s00256-020-03479-9

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  • DOI: https://doi.org/10.1007/s00256-020-03479-9

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