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FIG 2. Patient 15 with MELAS.
A and B, Axial FLAIR images demonstrate multiple cortical strokelike lesions, the largest of which was located along the parieto-occipital cortex (not shown). Tiny frontal and parietal cortical hyperintensities and the VOIs used for spectroscopy are visible.
C and D, Spectra reveal high lactate (Lac) and the 0.9 ppm signal (Lip/aa) not only into the damaged cortex (C) but also into the normal-appearing parietal cortex (D). A significant decrease of NAA may also be appreciated in the spectrum in C. Cho indicates choline; Cr, creatine.
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