MR Imaging and Proton Spectroscopy of Neuronal Injury in Late-Onset G_M2 Gangliosidosis

A, top left, Axial T2-weighted image from a 54-year-old late-onset G_M2G patient superimposed with the 5 × 5 cm² VOI. Right, ¹H spectrum from the cerebellum (arrow).

B, bottom left, Corresponding section from a 52-year-old healthy control superimposed with the 5 × 5 cm² VOI. Right, Arrow indicates analogous region for metabolite comparison. Both spectra are on the same scale. Note the dramatic atrophy of the cerebellar folia and vermis in the patient and consequent lower metabolites levels reflecting larger partial CSF volume contamination.