Reversible lesions in the brain parenchyma in Wilson's disease confirmed by magnetic resonance imaging:earlier administration of chelating therapy can reduce the damage to the brain

作     者：Dusko B.Kozic Igor Petrovic Marina Svetel Tatjana Pekmezovic Aleksandar Ragaji Vladimir S.Kostic 

作者机构：Diagnostic Imaging CenterInstitute of OncologySchool of MedicineUniversity of Novi SadPut Doktora Goldmana 421204 Sremska KamenicaSerbia Institute of Neurology Clinical Centre of SerbiaSchool of MedicineUniversity of BelgradeDr Subotica 611000BelgradeSerbia Institute of EpidemiologySchool of MedicineUniversity of BelgradeDr Subotica 611000BelgradeSerbia 

出 版 物：《Neural Regeneration Research》 (中国神经再生研究（英文版）)

年 卷 期：2014年第9卷第21期

页      面：1912-1916页

核心收录：

学科分类：06[历史学] 07[理学] 0809[工学-电子科学与技术（可授工学、理学学位）] 060109[历史学-专门考古] 070205[理学-凝聚态物理] 08[工学] 0710[理学-生物学] 0601[历史学-考古学] 1002[医学-临床医学] 060305[历史学-专门史与整体史] 1001[医学-基础医学(可授医学、理学学位)] 0805[工学-材料科学与工程（可授工学、理学学位）] 080502[工学-材料学] 0603[历史学-世界史] 0702[理学-物理学] 

基　　金：supported by a grant from the Ministry of Science and Technological Development of Serbia Scientific Project Number 175090 

主　　题：nerve regeneration Wilson’s disease diagnostic imaging chelating therapy magnetic resonance imaging delayed diagnosis metabolic disorders copper toxicity hepatic encephalopathy pontine myelinolysis cirrhosis neural regeneration 

摘      要：The aim of this study was to evaluate the resolution of brain lesions in patients with Wilson’s disease during the long-term chelating therapy using magnetic resonance imaging and a possible signiifcance of the time latency between the initial symptoms of the disease and the introduction of this therapy. Initial magnetic resonance examination was performed in 37 patients with proven neurological form of Wilson’s disease with cerebellar, parkinsonian and dystonic presentation. Magnetic resonance reexamination was done 5.7 ± 1.3 years later in 14 patients. Patients were divided into： group A, where chelating therapy was initiated 〈 24 months from the ifrst symp-toms and group B, where the therapy started≥ 24 months after the initial symptoms. Symmetry of the lesions was seen in 100% of patients. There was a signiifcant difference between groups A and B regarding complete resolution of brain stem and putaminal lesions （P= 0.005 andP=0.024, respectively）. If the correct diagnosis and adequate treatment are not established less than 24 months after onset of the symptoms, irreversible lesions in the brain parenchyma could be ex-pected. Signal abnormalities on magnetic resonance imaging might therefore, at least in the early stages, represent reversible myelinolisis or cytotoxic edema associated with copper toxicity.