Fig. 2.

H¹MRS spectra acquired at intermediate TE (135ms) in a pediatric brain stem tumor diagnosed as glioma. A non-specific spectra with an elevated choline at 3.2 and a decreased NAA peak at 2.02 with presence of a lipid peak at 1.3. Though these features are non-specific however presence of lipid with elevation of choline indicates an aggressive nature of tumor (which may point towards grade shift). The diagnosis of pediatric brain stem glioma remains obvious on imaging, the need of MRS if at all is for grading of tumor.