While doing the MRI to evaluate leukodystrophies check for the following :

• Location of white matter abnormalities
  
  
• Signal of white matter apart from the affected regions (hypomyelination)
  
  
• Cavitation
  
  
• Cerebellar involvement
  
  
• Head size
  
  
• Contrast enhancement
  
  

• Macrocephaly is seen in Krabbe's, Alexander's, Canavan's, Hurler syndrome.
  
  
• White matter changes located posteriorly: ALD
  
  
• White matter changes located anteriorly : Alexander's disease
  
  
• Periventricular involvement: MLD, ALD
  
  
• Involvement of arcuate fibers : Canavan's disease
  
  
• High density basal ganglia : Krabbe's disease
  
  
• Post contrast enhancement is seen in ALD, Alexander.
  
  

Alexander's disease (Fig 1) :

MLD (Fig 2) :

ALD (Fig 3) :

Last updated on 05-11-2001