FIG 1. Images obtained in a 69-year-old man with Klebsiella pneumoniae bacteremia, renal abscess, brain abscess, and endophthalmitis of the left eye.

A, Axial T1-weighted image (500/30[TR/TE]) before administration of contrast material.

B, Axial T2-weighted image (4000/100). The 2 x 2 x 2 cm voxel (box) in the lesion, adjacent brain tissue, and neighboring fat represents the ¹H-MRS volume of interest.

C, Axial contrast-enhanced T1-weighted MR image (500/30) shows a regular thin-walled ring-enhanced abscess approximately 9 mm in diameter in the superficial brain surface of right parietal region. Endophthalmitis in the left eye shows enhancement after contrast agent administration.

D, Axial diffusion-weighted (10,000/93; b = 1000 s/mm²) image shows marked hyperintensity in the abscess cavity and the left eye.

E, ADC map reveals slight hypointensity, representing restricted diffusion in the corresponding region.

F, In vivo ¹H-MR spectrum (2000/270) was unacceptable because of contamination from neighboring fat and a very small lesion. The resonances of choline (Cho), creatine (Cr), and N-acetylaspartate (NAA) were interpreted to be caused by partial volume effects of the adjacent brain tissue. A hump resonance (1–1.5 ppm) was identified, and lactate (Lac) peak contaminated by neighboring fat with a lipid (Lip) peak were suggested. Multiple small peaks at various frequencies are present; these peaks may represent noise or unassigned metabolites.