Objective   To explore the value of multivoxel 2D proton magnetic resonance spectroscopy (

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H-MRS) in differentiating diagnosis of intra-axial tuberculoma from high-grade glioma and metastatic brain tumor.     Methods   The conventional MR imaging and 2-D

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H-MR were performed in 52 cases (16 cases with  intra-axial tuberculoma

15 cases with hig

h-grade glioma

and 21 cases with metastatic brain tumor) before treatment or operation.

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H-MR was performed using PRESS sequence (TR1000 ms

TE144 ms). The ratios of Cho/Cr

Cho/NAA

and Cho/Cr-n from the solid part of the mass were calculated and analyzed in the three groups. The presence of lipid or lactate peak was also recorded.     Results   There was significant difference in the ratio of Cho/Cr in the mass of intra-axial tuberculoma

high-grade glioma

and metastatic brain tumor [(1.90±0.85)

(3.84±2.23) and (3.78±2.38)

respectively

P0.05

]

. There was also significant difference in the ratio of Cho/NAA in the mass of intra-axial tuberculoma

high-grade glioma

and metastatic brain tumor [(1.80±0.95)

(3.94±2.52)

and (3.18±2.40)

respectively

P0.05

]

. Significant difference was also found in the ratio of Cho/Cr-n in the mass of intra-axial tuberculoma

high-grade glioma

and metastatic brain tumor [(0.97±0.11)

(2.71±0.56)

and (2.42±0.54)

respectively

P0.01

]

. No significant difference was found in the positive expression of lipid or lactate in the mass of the three groups (P0.05).     Conclusion   Combined with clinical data

multivoxel 2-D

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H-MRS is quite effective in differentiating diagnosis of intra-axial tuberculoma from high-grade glioma and metastatic brain tumor.