Abstract

Maple syrup urine disease (MSUD) is caused by a genetic defect of branched-chain amino acids, which include leucine, isoleucine and valine. These patients usually present with acute metabolic crisis. MRI fi ndings are diffuse oedema involving the cerebellar white matter, pons, bulbus, cerebral peduncles, the posterior limbs of the internal capsules and the thalami. This MR image is called MSUD oedema. Diffusion-weighted imaging fi ndings are also present at the same areas. We report a newborn patient who had a prediagnosis of metabolic disease and who was determined to have MSUD by MR and diffusion-weighted MR imaging at 18 days of life. We want to emphasize that we should concentrate on the early diagnosis of MSUD with the characteristic MR and diffusion-weighted MR imaging fi ndings in a lethargic newborn before completing the metabolic work-up

Keywords: Maple syrup urine disease, Cranial magnetic resonance imaging, Newborn

References

  1. Kilicarslan R, Alkan A, Demirkol D, Toprak H, Sharifov R. Maple syrup urine disease: Diffusion-weighted MRI fi ndings during acute metabolic encephalopathic crisis. Jpn J Radiol 2012; 30:522-5.
  2. Cavalleri F, Berardi A, Burlina AB, Ferrari F, Mavilla L. Diffusion- weighted MRI of maple syrup urine disease encephalopathy. Neuroradiology 2002;44:499-502.
  3. Jong SH, Taik-Kun K, Baik-Lin E. Maple syrup urine disease encephalopathy: A follow-up study in the acute stage using diffusion-weighted MRI. Pediatr Radiol 2004;34:163-6.
  4. Jan W, Zimmerman RA, Wang ZJ, Berry GT, Kaplan PB, Kaye EM. MR diffusion imaging and MR spectroscopy of maple syrup urine disease during acute metabolic decompensation. Neuroradiology 2003;45:393-9.
  5. Cakmakci H, Pekcevik Y, Yis U, Unalp A, Kurul S. Diagnostic value of proton MR spectroscopy and diffusion-weighted MR imaging in childhood inherited neurometabolic brain diseases and review of the literature. European Journal of Radiology 2010;74:161-71.
  6. Patay Z. Diffusion–weighted MR imaging in leukodystrophies. Eur Radiol 2005;15:2284-2303.
  7. Lyon G, Fattal-Valevski A, Kolodny EH. Leukodystrophies: clinical and genetic aspects. Top Magn Resom Imaging 2006;17:219-42.
  8. Righini A, Ramenghi LA, Parini R, Triulzi F, Mosca F. Water apparent diffusion coeffi cient and T2 changes in the acute stage of maple syrup urine disease: evidence of intramyelinic and vasogenic– interstitial edema. J Neuroimaging 2003;13:162-5.

How to cite

1.
Taşkın BD, Bektaş Ö, Akkuzu E, Gündüz M, Ünal S, Güneş A, et al. MR and Diffusion-Weighted MR Images in Maple Syrup Urine Disease Encephalopathy. Turk J Pediatr Dis [Internet]. 2015 Apr. 1 [cited 2025 May 24];9(1):59-61. Available from: https://turkjpediatrdis.org/article/view/359