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Table 3 Useful MR spectroscopy and MR perfusion criteria for transdiploic lesions

From: Imaging of skull vault tumors in adults

 MR spectroscopyMR perfusion
MeningiomaAlanine (1.47 ppm): specific
↑Cho/Cr ratio
↑↑↑ rCBV (hipervascular)
Slow-progressive return to baseline
HemangiopericytomaMyoinositol: Specific
No alanine
↑ Cho/Cr ratio
Similar to Meningioma (hypervascular)
Lymphoma/small-blue round-cell↑↑↑ Choline
+/− Lipids or lactate
Recovery curve ABOVE baseline
Slightly ↑ CBV (ratio 1–1.5)
Metastasis↑↑ Lipids (tumor necrosis)Recovery curve BELOW baseline