The effectiveness of MRI for infratentorial lesions of patients with Wilson's disease

Magnetic resonance imaging (MRI) was performed in 7 patients (four males and three females), with Wilson's disease. Their ages ranged from 18 to 28 years, with a mean of 23 years. Abnormalities were detected in all seven cases. The period from the appearance of neurologic symptoms to the MRI study ranged from about 6 months to 20 years. There was, however, no significant relationship between the MRI findings and the disease period stated above. In the MR images, lesions were found with a low intensity in T1-weighted images and with a high intensity in T2-weighted images. As supratentorial lesions, cerebral atropy was found in 3 patients. In addition, abnormalities in the signal intensity were found in the putamen in all seven patients, in the caudate nucleus in 1, in the thalamus in 4, and in the subcortical white matter in 2. Meanwhile, as infratentorial lesions, cerebellar atrophy appeared in 2 patients, while abnormalities of the signal intensity were detected in the midbrain in 5 and in the pons in 5. When MRI was compared with CT for the detection of a supratentorial lesion, CT found to detect only abnormal densities in 5 out of the 7 patients. In contrast, MRI showed abnormalities of the signal intensity in all seven cases. As for infratentorial lesions, MRI found abnormal signal intensities in 5 cases. On the contrary, CT showed atrophy, but no abnormal density. Unfortunately, however, no relationship was found between the neurological signs and the lesions as shown by MRI. In conclusion, MRI is superior to CT in imaging the location of Wilson's disease lesions, particularly infratentorial lesions. In one case, however, MRI showed abnormalities in the putamen in spite of the disappearance of extrapyramidal signs after treatment. (author)