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FIG 1. Images from the case of a 31-year-old man with MELAS syndrome, which was documented by a point mutation in the mitochondrial tRNA (Leu). T2-weighted MR image (T2 MRI) (2600/80/1) shows a large focal hyperintensity in the left parietal region, predominantly affecting the gray matter. This area corresponds to elevated choline (Cho), decreased N-acetylaspartate (NAA), and markedly elevated lactate (Lac) on the multisection spectroscopic imaging metabolic maps. In addition, multisection spectroscopic images show globally elevated lactate, which is greatest in the left parietal strokelike lesion, next highest in the remaining gray matter (G.M.) and CSF, and lowest in the white matter. R., right; L., left.
