Face of panda sign (Wilson disease).

Imaging Technique:

The following  pulse sequences for the IAM & brain  were obtained  on a high field MRI.
Thin high resolution Axial & Coronal T2W VISTA images for IAM
Axial DW & T2 weighted images for brain

Observations

The IAM, 7th & 8th nerves, cochlea, semicircular canals and CPA cisterns are normal bilaterally.

    * Extra axial spaces: Normal in size and morphology
    * Hemorrhage: none    
    * Ventricular system: Normal in size and morphology
    * Basal cisterns: normal
    * Cerebral parenchyma: normal 
    * Midline shift: none
    * Cerebellum: normal
    * Brainstem: T2-weighted axial MRI images demonstrates symmetric hyperintense signals in the putamen and thalami “face of the giant panda” in midbrain with high signal in tegmentum and sparing of red nuclei.

Other:
    * Calvarium: normal
    * Vascular system: normal
    * Visualized Paranasal sinuses: Normal
    * Visualized Orbits: normal
    * Visualized upper cervical spine: normal
    * Left/right mastoid air cells: Normal

Impression:

• In light of above mentioned signs; picture is suggestive of Wilson disease for clinical correlation.


Reported By : DR.MOHAMMED MOHYELDIN
 Consultant-Radiologist
Report Status : Validated / Validated By :  Dr.Mohammed Mohyeldin