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Answer 11
  1. Biopsy of the liver. Wilson’s disease is a disease of copper metabolism that is associated with cirrhosis of the liver and degenerative changes in the basal ganglia. Decreased serum copper and ceruloplasmin and increased urinary copper can help point to a diagnosis, but the disease is most accurately diagnosed with liver biopsy. MRI may show atrophy of the cortex, cerebellum, and brainstem and ventricular dilatation, but these findings are nonspecific.2 Patients with hepatic symptoms may have increased signal in the basal ganglia on T1-weighted images.2

     Aisen AM, Martel W, Gabrielsen TO, et al. Wilson disease of the brain. MR imaging. Radiology 1985;157:137-41.

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