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FIG 3. (Case 1 and 2). MR spectroscopy shows increased lactate levels and reduced levels of choline and myo-inositol. For comparison, we added the data from Verheggen's patient (14). 1H MR spectra 1.5-T whole-body system (Sonata; Siemens, Erlangen, Germany) or 2-T whole-body system (Medsped S200 Avance; Bruker, Karlsruhe, Germany) with a gradient insert of 30mT/m stength and 190 ms ramp time were localized with a point-resolved spectroscopy select sequence (3000/30 or 128/88 or 20mm3 [TR/TE/repetitions/volume of interest]). A water suppression preparation period using three optimized chemical shift selective cycles was applied before each measurement. For each localization, a reference scan without water suppression was acquired. Spectra were analyzed using the LCModel software with the appropriate reference spectra
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