¹H MRS of high grade astrocytomas: Mobile lipid accumulation in necrotic tissue

Sixty-four samples from six grade 4 astrocytomas were investigated ex vivo by 1H MRS at 360 MHz and subsequently by histopathology to obtain percentages of viable and necrotic tumour and grey and white matter. MR-visible lipids were detected in 87% of tumour samples. Necrotic foci were < 3 x 3 x 6 mm3. The means of the intensities/unit weight tissue of the lipid resonances at 5.33, 2.80, 1.29 and 0.89 ppm were significantly higher (p < 0.05) for three sets of comparisons: samples with 85-100% vs 50-75%; with 50-75% vs 10-40% and with 10-40% vs 0-5% necrosis. For the lipid resonance at 2.04 ppm the difference in the means was significant only for samples with 50-75% compared to those with 85-100% necrosis, because for samples with < 50% necrosis resonances from glutamine and possibly small amounts of glutamate, gamma-aminobutyrate and N-acetylaspartate anions contribute significantly to the spectral area at 2.0 ppm. We conclude that necrotic foci below MRI resolution yield the resonances at 1.3 and 0.9 ppm, and contribute to the intense resonance at 2.0 ppm observed in in vivo 1H spectra of some high grade astrocytomas.