Normal Spectrum x x x x x x x x x x x xxxxx xxxxxxxxxxx xxxxxx xxxxxxx Choline Creatine NAA Lactate

Rules of Thumb

1. Low grade tumor and demyelination can look identical.

2. Very high choline levels usually indicates tumor.

3. Infarct shows elevated lactate and decreased other values.

4. Increased lactate in the CSF can be seen in NPH.

5. Decreased NAA indicates neuronal loss (including neuronal loss seen in tumor).

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