OBJECTIVE: Magnetic resonance spectroscopy ( STUDY DESIGN: 46 very preterm infants (VP) were evaluated by magnetic resonance imaging and RESULT: The Lipids/Creatine, Choline/Creatine, N-acetyl aspartate/Choline, Lactate/N-acetyl aspartate, and Lactate/Creatine ratios differed between VP infants with moderate+severe brain damage and those without brain injury. Moreover, VP infants with moderate+severe brain damage had higher Lactate/ N-acetyl aspartate and Lactate/Creatine ratios than HIE group. CONCLUSION: There were significant differences in the cerebral metabolite profile at TEA between VP infants with and without brain injury. The