PMC8900677_01
(A, B) T2-weighted images from the first case revealing cystic injury in the white matter and cerebellum; (C) 1H-MRS from case one showing elevated lactate doublet peak at 1.33 ppm. The quantified metabolite ratios to creatine (Cr) were NAA/Cr = 0.344, Cho/Cr = 0.384 and Lac/Cr = 2.013. Raw spectrum in grey and fitted to basis spectra in heavy black line.
nihms-1598245-f0001.jpg
PMC8900677_01_nihms-1598245-f0001.jpg
F1
Proton spectroscopy detected an elevated lactate peak at 1.33 ppm [Fig. 1].
PMC8900677_02
1H-MRS from case two showing elevated lactate doublet peak at 1.33 ppm. The metabolite ratios to creatine (Cr were NAA/Cr = 0.763, Cho/Cr = 0.117 and Lac/Cr = 1.44. Raw spectrum represented by light grey line and fitted to basis spectra by heavy black line.
nihms-1598245-f0002.jpg
PMC8900677_02_nihms-1598245-f0002.jpg
F2
An elevated lactate peak at 1.33 ppm was detected on (1H-MRS) [Fig. 2].