This study was aimed to explore the value of quantitative proton MR spectroscopy (1H-MRS) in the differentiation of benign and malignant meningioma. 23 cases, including 19 benign (grade I) and 4 malignant (grade II-III) meningiomas, underwent single voxel 1H-MRS (TR/TE = 2000 ms/68, 136, 272 ms). T2 relaxation time of tissue water and choline were estimated by an exponential decay model. Choline concentration was calculated using tissue water as the internal reference, and corrected according to intra-voxel cystic/necrotic parts. Tissue water T2 of benign and malignant meningiomas were (105 +/- 41) ms and (151 +/- 42) ms, respectively. The difference was statistically significant (P = 0.033). While Choline T2 of benign and malignant meningiomas were (242 +/- 73) ms and (316 +/- 102) ms respectively, the difference was not significant (P = 0.105). Choline concentration was (2.86 +/- 0.86) mmol/ kg wet weight in benign meningiomas and (3.53 +/- 0.60) mmol/kg wet weight in malignant ones; after correction they increased to (2.98 +/- 0.93)mmol/kg wet weight and (4.58 +/- 1.22) mmol/kg wet weight, respectively, and the difference was significant (P = 0.019). In conclusion, quantitative 1H-MRS is useful for the differentiation of benign and malignant meningioma by T2 relaxation time and absolute choline concentration.

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