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MR spectroscopy of neonate with excess glycine

Case Study
Van Cauter, Sofie, M.D. University Hospitals Leuven • Belgium

Patient history

Four-day-old neonate with intractable seizures. Transcranial ultrasound showed a hypoplasia of the corpus callosum. Blood and spinal fluid had slightly elevated glycine.

MR examination

The Achieva 3.0T TX was used to perform brain spectroscopy.


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Images

 IR TSE
IR
TSE
The Achieva 3.0T TX was used to perform brain spectroscopy.
 Spectra acquired with TE 35 ms (top), TE 144 ms (center) and TE 288 ms (bottom).
Spectra acquired with TE 35 ms (top), TE 144 ms (center) and TE 288 ms (bottom).




Anatomical MR images confirmed the tic corpus callosum. No other structural anomalies are seen. Spectroscopy was performed with three different TEs (35 ms, 144 ms and 288 ms). In the short TE spectrum a clearly elevated peak is seen at 3.6 ppm, which corresponds to myoinositol and/or glycine. Due to strong J-coupling, myoinositol is no longer depictable on TE spectra. The peak is visible at TE 144 and TE 288 and can therefore be assigned to glycine. In physiological circumstances, glycine is present in non-detectable amounts in the human brain.

Diagnosis

Due to an inherent disorder in the glycine metabolism in this patient, glycine accumulaties in the body. Excess glycine in the brain and the organs results in serious medical problems, including encephalopathy.

Clinical impact of fast 3.0T MR spectroscopy

Applying SENSE in two directions has allowed the Leuven team to dramatically shorten the scan time of MR spectroscopic imaging (MRSI) in the brain to about three and a half minutes without loss of spectral or spatial resolution, while maintaining sufficient SNR. These shorter scan times make it practical to include MR spectroscopy in routine brain MR exams.



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Sep 20, 2011

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Case Study
Achieva 3.0T
Brain, glycine, neonate, neuro, Spectroscopy
 

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