The T2W image (Left) shows brain volume loss. The white matter is high signal
because it is not myelinated. The FLAIR image looks like a T1W image because
there is essentially no myelination of the lobar white matter.
Coronal T1W images reveal some myelination of the cerebellum, brain stem, and
internal capsules but little in the lobar white matter. Overall, the pattern represents
markedly delayed myelination for a 7 year old boy.
MR spectroscopy shows decreased NAA and increased glutamates, lipids and lactate, as well
as a ketone peak at 2.2 ppm due to metabolic acidosis. Key words: mri mrs metabolic
Leigh's disease with lactic acidosis