Abstract: Objective Magnetic resonance imaging (MRI) images of 60 pediatric patients with hepatic and cerebral hepatomegaly were analyzed. Methods Sixty children with Wilson′s disease confirmed by genetic testing admitted to the Second Affiliated Hospital of Zhengzhou University between between January 2023 and January 2026 were divided into the brain type group (n=28) and the liver type group (n=32) according to the type of disease occurrence. The clinical features and imaging characteristics of the two groups were compared, and the value of imaging indicators in identifying pediatric patients with hepatic and cerebral hepatomegaly was analyzed using receiver operating characteristic curve (ROC). Results The serum copper levels and ceruloplasmin levels of patients in the brain group were (10.6±3.5) μmol/L and (81.3±35.2) mg/L, respectively, which were lower than those in the liver group [(15.3±5.2) μmol/L and (135.6±56.9) mg/L, respectively], the age of onset was (7.2 ± 1.1) years in the brain-type group, which was lower than that in the liver group [(8.6±2.5) years], and the duration of onset was (2.6±1.2) years in the brain group, which was higher than that in the liver group [(1.2±0.8) years, P<0.05]; The rate of abnormal MRI signals in the nucleus accumbens, caudate nucleus, midbrain, pons, and medulla oblongata, and the T2WI-weighted imaging lesion involvement scores were 89.29%, 78.57%, 71.43%, 100.00%, 92.86%, (2.5±1.1), (1.20±0.30), (0.90±0.40), (1.1±0.3), and (0.80±0.30) points, respectively, in the brain-type group. ) points, (0.8±0.3) points, all higher than the liver type group [37.50%, 40.63%, 40.63%, 62.50%, 43.75%, (0.7±0.2) points, (0.20±0.06) points, (0.20±0.05) points, (0.4±0.1) points, (0.10±0.02) points, respectively]. Patients in the cerebral group had higher involvement scores in the pallidum, nucleus accumbens, caudate nucleus, thalamus, midbrain, pons, and medulla oblongata with (1.8 ± 0.7), (1.4 ± 0.8), (0.7 0± 0.30), (1.8 ± 0.6), (0.7 ± 0.3), (0.6 ± 0.2), and (0.4 ± 0.2) points, respectively, than those in the hepatic group [(1.3 ± 0.5), (0.6 ± 0.2), (0.10 ± 0.04), (0.9 ± 0.2), (0.2 ± 0.1), (0.3 ± 0.1), and (0.1 ± 0.02) points, P<0.05]; The results of ROC curve analysis showed that serum copper levels, ceruloplasmin levels, age at onset, disease duration, T2WI-weighted imaging lesion involvement score and extent of involvement score were of great value in differentiating between hepatic-type and neurological-type Wilson disease in children. Conclusion The serum copper level, ceruloplasmin level, age of onset, disease duration, T2WI-weighted imaging lesion involvement score and involvement score can be used to differentiate between hepatic-type and neurological-type Wilson disease in children and provide assistance for the clinical management of Wilson′s disease.

Key words: Liver type, Brain type, Wilson′s disease, Magnetic resonance imaging