FIG 5. Normal spectra in a 2-day-old infant with neonatal encephalopathy and abnormal neurologic development at age 12 months.

A, Spectrum from voxel in the basal nuclei voxel shows normal NAA, choline, and creatine/phosphocreatine peaks (compare with fig 1A). Minimal lactate (arrow) is seen at 1.31 ppm; this level of lactate was seen in many infants who developed normally and was interpreted as normal.

B, Spectrum from the watershed zone voxel also shows normal relative peak areas for choline, creatine/phosphocreatine, and NAA (compare with fig 1B). No lactate is appreciated in this voxel.

C, Axial SE (500/12) image at the level of the basal nuclei shows globular hyperintensity (arrows) in the lentiform nuclei, indicative of an injury more than 1 week old.

D, Axial SE (500/12) image in a child with normal neonatal course and normal postnatal development shows the normal appearance of the neonatal basal nuclei. The hyperintensity in the vein of Galen and superior sagittal sinus is the result of inflow of unsaturated protons.