title: MRI appearances of metachromatic leukodystrophy.
abstract: BACKGROUND
  The leukodystrophies constitute a wide spectrum of cerebral disorders of varying etiology. The imaging appearances on CT and MRI are recognizable as abnormalities of white matter; however, it may be impossible to arrive at the correct diagnosis based on imaging studies alone.
  
  
  METHODS
  Three patients of varying age and clinical symptomatology diagnosed with metachromatic leukodystrophy (MLD) had remarkably similar MRI appearances. A "tigroid" or "leopard-skin" appearance was demonstrated within deep white matter in each case.
  
  
  RESULTS
  All of the patients had biochemical confirmation of MLD.
  
  
  CONCLUSIONS
  Although the "tigroid" pattern previously was considered to be pathognomonic of Pelizaeus-Merzbacher disease, the diagnosis of MLD must now be considered when these MRI appearances are encountered.
authors.affiliation: Department of Radiology, St. Christopher's Hospital for Children, MCP. Hahnemann School of Medicine, Erie Avenue and Front Street, Philadelphia, PA 19134-1095, USA.
authors.forename: E N
authors.initials: EN
authors.lastname: Faerber
authors.forename: J
authors.initials: J
authors.lastname: Melvin
authors.forename: E M
authors.initials: EM
authors.lastname: Smergel
mesh_terms: D001921:Brain / Q000473:pathology*; D002553:Cerebroside-Sulfatase / Q000172:deficiency; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D003711:Demyelinating Diseases / Q000175:diagnosis; D003937:Diagnosis, Differential; D002549:Diffuse Cerebral Sclerosis of Schilder / Q000175:diagnosis; D005260:Female; D005682:Gadolinium; D006801:Humans; D007966:Leukodystrophy, Metachromatic / Q000097:blood / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D005682:Gadolinium; D002553:Cerebroside-Sulfatase