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KMID : 0880420100110060665
Korean Journal of Radiology
2010 Volume.11 No. 6 p.665 ~ p.672
Clinical Application of Liver MR Imaging in Wilson¡¯s Disease
Cheon Jung-Eun

Kim In-One
Seo Jeong-Kee
Ko Jae-Sung
Lee Jeong-Min
Shin Cheong-Il
Kim Woo-Sun
Yeon Kyung-Mo
Abstract
Objective To determine whether there is a correlation between liver MR findings and the clinical manifestations and severity of liver dysfunction in patients with Wilson¡¯s disease.

Materials and Methods Two radiologists retrospectively evaluated MR images of the liver in 50 patients with Wilson¡¯s disease. The Institutional Review Board approved this retrospective study and informed consent was waived. MR images were evaluated with a focus on hepatic contour abnormalities and the presence of intrahepatic nodules. By using Fisher¡¯s exact test, MR findings were compared with clinical presentations (neurological and non-neurological) and hepatic dysfunction, which was categorized by the Child-Pugh classification system (A, B and C). Follow-up MR images were available for 17 patients.

Results Contour abnormalities of the liver and intrahepatic nodules were observed in 31 patients (62%) and 25 patients (50%), respectively. Each MR finding showed a statistically significant difference (p < 0.05) among the three groups of Child-Pugh classifications (A, n = 36; B, n = 5; C, n = 9), except for splenomegaly (p = 0.243). The mean age of the patients with positive MR findings was higher than that of patients with negative MR findings. For patients with Child-Pugh class A (n = 36) with neurological presentation, intrahepatic nodules, surface nodularity, and gallbladder fossa widening were more common. Intrahepatic nodules were improved (n = 8, 47%), stationary (n = 5, 29%), or aggravated (n = 4, 24%) on follow-up MR images.

Conclusion MR imaging demonstrates the contour abnormalities and parenchymal nodules of the liver in more than half of the patients with Wilson¡¯s disease, which correlates with the severity of hepatic dysfunction and clinical manifestations.
KEYWORD
Hepatolenticular degeneration, Liver, Magnetic resonance (MR)
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