A magnetic resonance approach to metabolic disorders in childhood.

INTRODUCTION Inborn errors of metabolism are a difficult group of disorders to diagnose. Clinical signs and symptoms overlap among the different diseases, biochemical tests are often nonspecific or unrevealing, and genetic analyses are time consuming, expensive, and often not commercially available. Imaging can aid in diagnosing some disorders, but the imaging findings of many disorders seem to overlap, particularly as more and more disorders are identified and described. DEVELOPMENT Several groups have proposed an imaging approach based upon pattern recognition on magnetic resonance imaging, supplemented by metabolic data from proton magnetic resonance spectroscopy and microstructural data, as assessed by diffusion weighted imaging. CONCLUSION When properly used, this pattern recognition approach in conjunction with the other imaging tools can be very useful for separating the complex group of metabolic disorders into more manageable groups. Indeed, sometimes this approach allows a specific diagnosis to be made.