MR OF THE LIVER IN WILSONS-DISEASE

To show that Wilson's disease is one likely cause of multiple low-inte nsity nodules of the liver we obtained MR images in 16 patients with c linically and histopathologically confirmed Wilson's disease. Correspo nding to morphological changes MRI enabled the subdivision of the pati ents into two groups. Using a T-2-weighted spin-echo sequence (TR/TE = 2000/45-90) liver parenchyma showed multiple tiny low-intensity nodul es surrounded by high-intensity septa in 10 out of 16 patients. 5 pati ents had also low-intensity nodules in T-1-weighted images (TR/TE = 60 0/20). In patients of this group histopathology revealed liver cirrhos is (n = 7) and fibrosis (n = 2). Common feature of this patient group was marked inflammatory cell infiltration into fibrous septa, increase of copper concentration in liver parenchyma and distinct pathological changes of laboratory data. In the remaining 6 patients no pathologic al change of liver morphology was demonstrated by MRI corresponding to slight histopathological changes of parenchyma and normal laboratory data. As low-intensity nodules surrounded by high intensity septa can be demonstrated in patients with marked inflammatory infiltration of l iver parenchyma MRI may help to define Wilson patients with poorer pro gnosis. In patients with low-intensity nodules of the liver and unknow n cause of liver cirrhosis laboratory data and histopathology should b e checked when searching for disorders of copper metabolism.