Atypical CT scans in adrenoleukodystrophy

Computed tomography has become a valuable tool in the diagnosis of adrenoleukodystrophy because of a characteristic CT pattern of symmetrical low density areas in the parietooccipital region often with a peripheral rim of enhancement. However, a few cases have been reported that depart from this classic pattern. We have recently observed an atypical CT pattern where instead of diminished attenuation in the white matter, extensive calcifications were seen with a symmetric distribution in the parietooccipital regions. There was no associated contrast enhancement.