Quantitative proton magnetic resonance spectroscopy of the human cervical spinal cord at 3 Tesla

Cervical spinal cord spectroscopy has the potential to add metabolic information to spinal cord MRI and improve the clinical evaluation and research investigation of spinal cord diseases, such as multiple sclerosis (MS) and intraspinal tumors. However, in vivo proton MR spectroscopy (H-1-MRS) of the spinal cord is difficult to perform due to magnetic field inhomogeneities, physiological movements, and the size of the anatomical region of interest (ROI). For these reasons, few spinal cord H-1-MRS studies have been undertaken and two preliminary studies on a 3T system were only recently presented as abstracts. In this work we demonstrate the feasibility of cervical spinal cord quantitative 1H-MRS on a clinical 3T system, propose a study protocol, and report quantification results obtained from healthy volunteers. The main metabolite concentration ratios obtained in 10 healthy subjects, as provided by LCModel, were as follows: total N-acetyl aspartate/creatine (tNAA/Cr) 1.4 +/- 0.3, choline/creatine (Cho/Cr) 0.5 +/- 0.1, and myoinositol/creatine (ml/Cr) 1.7 +/- 0.2. A significant difference was found between spinal cord tNAA, Cr, Cho, and ml concentration ratios and brainstem concentrations previously acquired on the same system.