Abstract

Proton MR Spectroscopy measures the ratios of N-acetyl aspartate (NAA) to creatine (Cr) in the brain as a function of neuronal injury or dysfunction. We hypothesized that children with DKA might have lower brain NAA/ Cr ratios, indicating subtle neuronal damage. During DKA treatment, 29 children underwent cerebral proton MR spectroscopy two to twelve hours after starting treatment and 72 hours or more after recovering from the episode. We measured the NAA, Cr, and choline peak heights in three brain regions: the basal ganglia, periaqueductal gray matter, and occipital gray matter. In DKA-related cerebral edema, these areas were found to be more susceptible to neurologic injury in previous studies. Throughout the acute illness and recovery periods, we compared the ratios of NAA/Cr and Cho/Cr.