PMC2718128_01
A control spectrum of stimulated-echo acquisition mode (STEAM) sequence (TR/TE, 3000/166) obtained at the parietal white matter of a one-month-old infant with neonatal seizure, for comparison. NAA, N-acetylaspartate; tCr, total creatine; Cho, choline-containing compounds
kjr-2-239-g001.jpg
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F1
The spectra obtained were compared with those from an age-matched control subject (Fig. 1).
Proton MR imaging and spectra obtained from an infant with nonketotic hyperglycinemia. All spectra are scaled individually and cannot be directly compared.. A. Axial T1-weighted (600/16) image obtained with a spin-echo sequence and 18-cm field of view, 256 x 192 matrix, and 5-mm contiguous sections, with the voxel location as indicated for proton MR spectroscopy.. B. A spectrum obtained from the parietal white matter shows a prominent singlet at 3.55 ppm (arrow), which is assigned to glycine. The peak intensity of glycine is much higher than that of Cho (glycine/Cho, 1.58) and of tCr (glycine/tCr, 2.42).. C. A follow-up spectrum obtained after treatment and symptomatic improvement shows a slightly decreased peak glycine intensity. The observed peak intensity is similar to that of Cho (glycine/Cho, 1.05) and slightly higher than that of tCr (glycine/tCr, 1.31).. D. A final spectrum, obtained after symptoms worsened, shows a markedly increased peak glycine intensity. The observed peak intensity is again much higher than that of Cho (glycine/Cho, 1.80) and of tCr (glycine/tCr, 1.60), and peak lactate intensity has increased to 1.33 ppm.
kjr-2-239-g002.jpg
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F2
Final follow-up MRS on the 17th day revealed, in comparison with the second MRS study, a prominently increased glycine/Cho ratio (1.80), a slightly increased glycine/total Cr ratio (1.60) and a newly occorring lactate, at 1.3 ppm (Fig. 2D).
PMC2718128_02
Proton MR imaging and spectra obtained from an infant with nonketotic hyperglycinemia. All spectra are scaled individually and cannot be directly compared.. A. Axial T1-weighted (600/16) image obtained with a spin-echo sequence and 18-cm field of view, 256 x 192 matrix, and 5-mm contiguous sections, with the voxel location as indicated for proton MR spectroscopy.. B. A spectrum obtained from the parietal white matter shows a prominent singlet at 3.55 ppm (arrow), which is assigned to glycine. The peak intensity of glycine is much higher than that of Cho (glycine/Cho, 1.58) and of tCr (glycine/tCr, 2.42).. C. A follow-up spectrum obtained after treatment and symptomatic improvement shows a slightly decreased peak glycine intensity. The observed peak intensity is similar to that of Cho (glycine/Cho, 1.05) and slightly higher than that of tCr (glycine/tCr, 1.31).. D. A final spectrum, obtained after symptoms worsened, shows a markedly increased peak glycine intensity. The observed peak intensity is again much higher than that of Cho (glycine/Cho, 1.80) and of tCr (glycine/tCr, 1.60), and peak lactate intensity has increased to 1.33 ppm.
kjr-2-239-g002.jpg
PMC2718128_03_kjr-2-239-g002.jpg
F2
Final follow-up MRS on the 17th day revealed, in comparison with the second MRS study, a prominently increased glycine/Cho ratio (1.80), a slightly increased glycine/total Cr ratio (1.60) and a newly occorring lactate, at 1.3 ppm (Fig. 2D).
PMC2718128_03
Proton MR imaging and spectra obtained from an infant with nonketotic hyperglycinemia. All spectra are scaled individually and cannot be directly compared.. A. Axial T1-weighted (600/16) image obtained with a spin-echo sequence and 18-cm field of view, 256 x 192 matrix, and 5-mm contiguous sections, with the voxel location as indicated for proton MR spectroscopy.. B. A spectrum obtained from the parietal white matter shows a prominent singlet at 3.55 ppm (arrow), which is assigned to glycine. The peak intensity of glycine is much higher than that of Cho (glycine/Cho, 1.58) and of tCr (glycine/tCr, 2.42).. C. A follow-up spectrum obtained after treatment and symptomatic improvement shows a slightly decreased peak glycine intensity. The observed peak intensity is similar to that of Cho (glycine/Cho, 1.05) and slightly higher than that of tCr (glycine/tCr, 1.31).. D. A final spectrum, obtained after symptoms worsened, shows a markedly increased peak glycine intensity. The observed peak intensity is again much higher than that of Cho (glycine/Cho, 1.80) and of tCr (glycine/tCr, 1.60), and peak lactate intensity has increased to 1.33 ppm.
kjr-2-239-g002.jpg
PMC2718128_03_kjr-2-239-g002.jpg
F2
Final follow-up MRS on the 17th day revealed, in comparison with the second MRS study, a prominently increased glycine/Cho ratio (1.80), a slightly increased glycine/total Cr ratio (1.60) and a newly occorring lactate, at 1.3 ppm (Fig. 2D).