title: Clinical application of liver MR imaging in Wilson's disease.
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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, and the Institute of Radiation Medicine, SNUMRC, Seoul, Korea.
authors.forename: Jung-Eun
authors.initials: JE
authors.lastname: Cheon
authors.forename: In-One
authors.initials: IO
authors.lastname: Kim
authors.forename: Jeong Kee
authors.initials: JK
authors.lastname: Seo
authors.forename: Jae Sung
authors.initials: JS
authors.lastname: Ko
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Cheong-Il
authors.initials: CI
authors.lastname: Shin
authors.forename: Woo Sun
authors.initials: WS
authors.lastname: Kim
authors.forename: Kyung Mo
authors.initials: KM
authors.lastname: Yeon
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006527:Hepatolenticular Degeneration / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D018709:Statistics, Nonparametric