Wilson’s Disease and Clinical MR Imaging Application ence was noted for age at MR imaging among the three groups of Child-Pugh classification (p = 0.036). All of the patients with a neurological presentation were categorized as class A. Another 38 patients with non-neurological presentation were categorized as class A (n = 24, 63%), class B (n = 5, 13%), and class C (n = 9, 24%). There was a statistically significant difference for Child-Pugh classifica- tion between neurological and non-neurological presenta- tions (p = 0.048). The clinical findings of 50 patients are summarized in Table 1. MR Imaging Findings Twenty-five patients (50%) demonstrated hypointense hepatic nodules on T2-weighted images. The nodules were granular (grade 1, ≤ 3 mm in diameter) in 13 patients (Figs. 1A, 2A), or macronodular (grade 2, > 3 mm in diameter) in 12 patients (Figs. 1B, 3A, 4A). These nodules were hyperintense (n = 14) or isointense, or slightly hypointense (n = 11) as seen on T1-weighted images (Figs. 3B, 4B). Thirty-one patients (62%) showed contour abnormalities such as surface nodularity (n = 25), caudate hypertrophy (n = 10), or gallbladder fossa widening (n = 29) (Figs. 3, 4). Ascites, venous collaterals, and splenomegaly were observed in seven patients, 10 patients, and 40 patients, respectively. Edematous wall thickening of the gallbladder was observed in 12 patients, and a gallbladder stone or sludge in three patients (Fig. 4). Clinical Correlation of MR Imaging Findings In the 36 patients belonging to Child-Pugh class A, hypointense nodules as seen on T2-weighted images, were detected in 12 patients (33%) (grade 1 [n = 9, 25%] and grade 2 [n = 3, 8%]). Contour abnormalities of the liver were noted in 17 patients (47%). In the five patients categorized as Child-Pugh class B, hypointense nodules as seen on T2-weighted images, and contour abnormalities of the liver were detected in all patients. Macronodular lesions (grade 2, > 3 mm in diameter) were observed in three patients (60%) (Fig. 3). In the nine patients catego- rized as Child-Pugh class C, hypointense nodules as seen on T2-weighted images and contour abnormalities of the liver were noted in all patients except for one (89%). A C B Fig. 4. 24-year-old man with Wilson’s disease and advanced cirrhosis (Child-Pugh class C). A. Disseminated hyperintense nodules greater than 1 cm in size relative to liver parenchyma are seen on axial T2-weighted MR image. Note surface irregularity and parenchymal contraction of liver. B. T1-weighted axial image of liver shows multiple hyperintense nodules. Gallbladder stone (arrow) is seen as nodular hyperinten- sity near porta hepatis. C. Harvested liver during liver transplantation shows macronodular cirrhosis. There was no evidence of hepatocellular carcinoma. Korean J Radiol 11(6), Nov/Dec 2010 669