Figure 14.

Detection of ketone bodies in in vivo MRS (A) The MR spectrum of a 13-year-old boy with refractory epilepsy on ketogenic diet and unremarkable MR images shows a signal consistent with acetone (Acn) at 2.22 ppm and a doublet from β-hydroxybutyrate (βHB) centered at ≈1.19 ppm. Note that NAA is below normal for age. MR imaging in this patient was unremarkable. (B) The MR spectrum of a 11-year-old boy with abnormal MRI, a history of meningoencephalitis, and refractory epilepsy on ketogenic diet shows prominent Acn signal, elevated lactate (Lac) and glutamine (Gln), as well as drastically reduced NAA. Spectra were acquired on a 3T scanner with PRESS, TE = 35 ms, and TR = 2 s.