Diffusion MR Imaging Changes Associated with Wilson Disease

We herein report the case of a patient with Wilson disease. The patient underwent echo-planar diffusion MR imaging twice, 1.5 years apart. The lesions were in the putamina and caudate nuclei. At the first examination, undertaken after onset of extrapyramidal symptoms, a restricted diffusion pattern was evident. It is likely that this corresponded to cell swelling caused by the accumulation of copper. On the images obtained 1.5 years later, an opposite pattern (an elevated diffusion pattern) was noted. It is likely that this reflected necrosis, spongiform degeneration, and demyelination, which are among the known histopathologic changes associated with Wilson disease.