PMC6117375_01
Contrast enhanced brain MRI (A-D). Axial T2 weighted FLAIR images show extensive areas of increased signal symmetrically involving the middle cerebellar peduncles and cerebellar peridentate white matter (A) and the cerebral white matter (B,C).1H MR spectroscopy in the affected right parietal white matter (black box in C) shows increased peaks of choline (Cho) and lactate (Lac) and decreased peak of N-acetyl-aspartate (NAA).
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F1
A contrast enhanced brain MRI (Figure 1) showed a small hypophysis without focal abnormalities, extensive symmetric areas of increased T2 signal in the cerebral white matter including the internal capsule, the cerebral peduncles, middle cerebellar peduncles and the cerebellar peridentate white matter and marked brain atrophy, consistent with MLD at an advanced stage. Proton MR spectroscopy in the affected right parietal white matter showed increase of the choline, a decrease of the N-acetylasparate, and a peak of lactate (Figure 1).