Department of Radiology, Seoul National University College of Medicine, and the Institute of Radiation Medicine, SNUMRC, Seoul, Korea.
Korean J Radiol. 2010 Nov-Dec;11(6):665-72. doi: 10.3348/kjr.2010.11.6.665. Epub 2010 Oct 29.
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.
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.
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.
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.
确定威尔逊病患者的肝脏磁共振（MR）表现与肝功能障碍的临床表现和严重程度之间是否存在相关性。
两位放射科医生对 50 例威尔逊病患者的肝脏 MR 图像进行了回顾性评估。机构审查委员会批准了这项回顾性研究，豁免了知情同意。重点评估肝脏轮廓异常和肝内结节的存在。采用 Fisher 确切检验，将 MR 发现与临床表现（神经和非神经）和肝功能障碍进行比较，后者根据 Child-Pugh 分类系统（A、B 和 C）进行分类。17 例患者有随访 MR 图像。
31 例（62%）和 25 例（50%）患者分别观察到肝脏轮廓异常和肝内结节。每种 MR 发现均在三组 Child-Pugh 分类（A，n=36；B，n=5；C，n=9）之间存在统计学差异（p<0.05），脾肿大除外（p=0.243）。MR 检查结果阳性患者的平均年龄高于 MR 检查结果阴性患者。对于有神经表现的 Child-Pugh 分级 A 患者（n=36），肝内结节、表面结节和胆囊窝增宽更为常见。肝内结节在随访 MR 图像上改善（n=8，47%）、稳定（n=5，29%）或加重（n=4，24%）。
MR 成像显示超过一半的威尔逊病患者存在肝脏轮廓异常和实质结节，与肝功能障碍的严重程度和临床表现相关。
