Diseases with Gray Matter Involvement : MRI Approach

In evaluating inborn error of metabolism on MRI first important decision is whether the disease involves primarily gray matter or white matter.  Disorders that primarily affect cortical gray matter will show cortical thinning and prominent cortical sulci. The cerebral white matter will often have an abnormal appearance due to Wallerian degeneration of axons. However, white matter appearance can  be differentiated from that of primary white matter disorders which have a maintained volume.