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Developmental Delay in Children: Assessment with Proton MR Spectroscopy

Christopher G. Filippia, Aziz M. Uluga, Michael D. F. Decka, Robert D. Zimmermana and Linda A. Heiera

a From the Department of Radiology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York



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  		FIG 1. PRESS image (2000/144/8) demonstrates voxel placement in the frontal subcortical white matter (box). Voxels were used to assess NAA/Cr ratios and Cho/Cr ratios.



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  		FIG 2. Comparison of patient and control spectra in the group aged 2 years or younger.

A, Proton MR spectrum in left frontal white matter in a 1.5-year-old control subject demonstrates an NAA/Cr ratio of 2.12 and a Cho/Cr ratio of 1.81.

B, Proton MR spectrum from a voxel placed in the subcortical white matter of the left frontal lobe in a 1.5-year-old patient with mild developmental delay demonstrates a slightly higher Cho peak and higher Cho/Cr ratio of 2.01. This value, however, was not significantly different than that in the 1.5-year-old control subject. Likewise, the NAA peak is slightly lower and the NAA/Cr ratio of 1.94 is less than that in the control subject but not significantly different.



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  		FIG 3. Comparison of patient and control spectra in the frontal lobe subcortical white matter in the group aged older than 2 years.

A, Proton MR spectrum in a 5-year-old patient with mild developmental delay in language and coordination demonstrates marked increase in the Cho/Cr ratio to 1.79. There is a decrease in the NAA/Cr ratio to 2.06, which resembles the MR spectrum of a much younger child such as seen in the 1.5-year-old children in Fig 2.

B, Proton MR spectrum in a 5-year-old control patient demonstrates a pattern resembling that of an adult, with an NAA peak that is 2 times higher than the Cr peak and a Cho peak that is slightly elevated compared with the Cr peak. The NAA/Cr ratio of 2.50 and Cho/Cr ratio of 1.42 are normal.





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