Magnetic resonance imaging compared with computed tomography in adrenoleukodystrophy.

Adrenoleukodystrophy was diagnosed in two siblings and confirmed by analysis of very-long-chain fatty acids in skin fibroblasts. Both boys had computed tomograms (CTs) and magnetic resonance imaging (MRI) of the brain. In the most severely affected child, the CT and MRI examinations were both abnormal, but in the other child, the CT was mildly abnormal but the MRI was unequivocally abnormal. This suggests that MRI is more sensitive than CT in detecting the acute demyelinating changes of adrenoleukodystrophy and, in conjunction with very-long-chain fatty acid analysis, should be useful in screening unaffected or mildly affected siblings of patients with this disease.