Choline is a precursor of acetylcholine (ACH), a component of cell membranes which is commonly examined in MR spectroscopy. It resonates at 3.2 ppm chemical shift.
It is a marker of cellular membrane turnover and therefore elevated in neoplasms, demyelination and gliosis. In the setting of gliomas, elevated choline beyond the margins of contrast enhancement is suggestive of further extension of the neoplastic cells.
MR spectroscopy (MRS)
- Hunter's angle
- lactate peak: resonates at 1.3 ppm
- lipids peak: resonate at 1.3 ppm
- alanine peak: resonates at 1.48 ppm
- N-acetylaspartate (NAA) peak: resonates at 2.0
- glutamine-glutamate peak: resonate at 2.2-2.4 ppm
- gamma-aminobutyric acid (GABA) peak: resonate at 2.2-2.4 ppm
- citrate peak: resonates at 2.6 ppm
- creatine peak: resonates at 3.0 ppm
- choline peak: resonates at 3.2 ppm
- myo-inositol peak: resonates at 3.5 ppm