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Mitochondrial Encephalomyopathy: Comparison of Conventional MR Imaging with Diffusion-Weighted and Diffusion Tensor Imaging: Case Report

Charles B. Majoiea, Erik M. Akkermana, Christian Blankb, Peter G. Barthb, Bwee Tien Poll-Theb and G.J. den Heetena

a Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands
b Department of Pediatric Neurology, Academic Medical Center, Amsterdam, the Netherlands



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  		FIG 1. Images from the case of a 5-month-old male Caucasian patient who presented to a general hospital with a 4-day history of vomiting and diarrhea and was referred to our institution for further investigation.

A, Axial fast spin-echo T2-weighted MR image (3500/90/1 [TR/TE/NEX]) shows high signal intensity in the temporal white matter of both hemispheres. Subtle high signal intensity is shown in the globus pallidus (arrows).

B, Proton MR spectrum obtained from the left temporal white matter with a TE of 144 shows a large inverted doublet at 1.3 ppm, diagnostic of elevated lactate (C, choline; Cr, creatine; N, N-acetylaspartate; L, lactate).

C, Diffusion-weighted MR image shows restricted diffusion in the globus pallidus (arrows) and increased diffusion in the temporal white matter of both hemispheres.

D, ADC map corresponding to area shown in C shows decreased ADC in globus pallidus (arrows) and increased ADC in temporal white matter.

E, Fractional anisotropy map shows decreased anisotropy in the temporal white matter.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X