| [Objective] Difficulties in the early diagnosis of intracranial abscess are mainly due to the combination of unspecified clinical findings and similarities in the morphologic appearance of some intracranial cystic lesions, such as cystic glioma and metastases. Some authors have suggested in vivo proton MR spectroscopy as a diagnostic technique in cases of suspected intracerebral abscess. Specific resonance peaks that are not detected in intracranial cystic lesions characterize brain abscesses. The aim of this study was to show distinctive resonance pattern in 11 cases intracranial abscess and 19 cases cystic lesions and to evaluate these specific resonance peaks.[Methods] Characteristics of ~1H-MRS in 11 patients with brain abscesses and 19 with cystic or necrotic intracranial tumors were analyzed and compared. Peak assignment was based on reference values from in vivo and vitro studies.[Results] Among 11 patients with brain abscesses, 10 cases showed lactate (Lac) at 1.3 ppm, 9 cases showed the presence of cytosolic amino acid (AA) at 0.9 ppm, 6 cases showed alanine (Ala) at 1.5 ppm, 4 cases showed acetate (Ac) at 1.9 ppm and 2 patients showed succinate (Suc) at 2.4 ppm. 6 cases showed lipoid (Lip) peak at 0.9-1.3 ppm. One case showed NAA, Crand Cho peak at 2.0 ppm, 3.0 ppm and 3.2 ppm respectively. The AA, Ala, Ac and Suc peaks have not been detected in spectra from 19 cases cystic or necrotic intracranial tumors.[Conclusions] ~1H-MRS can reflect the different histochemical specificity of abscesses and cystic or necrotic tumors effectively. It has special value in the diagnosis and differentiation of brain abscess depending on the present of AA, Ala, Ac or Suc.
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