Fig 1.

TR/TE 1500/144 ms single-voxel spectroscopy of the right basal ganglia in a 14-year-old boy during 2 episodes of DKA 2 months apart. The first episode of DKA is shown on the top 2 spectra, and second episode, on the bottom 2 spectra. The first of each pair of spectra was obtained during DKA treatment, 9–12 hours after beginning therapy. The second of the pair was obtained after recovery. During the acute DKA episode, the NAA/Cr ratio is decreased compared with the postrecovery spectra. In addition, the NAA/Cr ratio is lower (1.76) after recovery from the second episode of DKA compared with the postrecovery spectra from the first episode (1.97). This suggests a degree of permanent neuronal dysfunction or loss resulting from DKA.