Linked Adrenoleucodystrophy (MR).

PROTOCOL:  
T2W  - Axial scans
T1W - Axial & Sagittal  scans
FLAIR - coronal scans
3D SPGR – Axial scans

FINDINGS:

-Evidence of symmetrical cerebral white matter signal change involving the posterior periventricular white matter (i.e. posterior cerebral, around splenium and peritrigonal white matter) with relative sparing of subcortical U-fiber involvement.

-No obvious focal lesion is seen.
-Third and lateral ventricles are normal in size and position.
-Cavum septum pellucidum.
-Brain stem and cerebellum are normal in appearance and signal intensities.
-Fourth ventricle is normal in position and size.


IMPRESSION:

• Picture is suggestive of X-linked adreno-leucodystrophy of the brain.
• Post study contrast is essential to narrow differential diagnosis of the case.
• Other differential diagnosis include:

-Periventricular leukodystrophy
• Periventricular gliosis and volume loss following hypoxia of prematurity; doesn't enhance.
-Neonatal hypoglycemia (acute and follow-up)
• May involve splenium, calcar avis, and posterior peri trigonal WM, but doesn't enhance.
-White matter disease with lactate (WML)
• Involves splenium, peri trigonal WM and corticospinal tracts, but doesn't enhance.
-Met achromatic leukodystrophy
• Involves splenium/peri trigonal WM, doesn't enhance.
-Alexander disease
• Enhances, but frontal not peri trigonal WM.


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Reported By : DR.MOHAMMED MOHYELDIN
 Consultant-Radiologist
Report Status : Validated / Validated By :  Dr.Mohammed Mohyeldin