Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Use of Magnetic Resonance Neurography for Evaluating the Distribution and Patterns of Chronic Inflammatory Demyelinating Polyneuropathy

  • Xiaoyun Su (Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Xiangquan Kong (Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Zuneng Lu (Department of Neurology, Renming Hospital of Wuhan University) ;
  • Min Zhou (Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Jing Wang (Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Xiaoming Liu (Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Xiangchuang Kong (Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology) ;
  • Huiting Zhang (MR Scientific Marketing, Siemens Healthineers) ;
  • Chuansheng Zheng (Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology)
  • Received : 2019.10.06
  • Accepted : 2019.12.19
  • Published : 2020.04.01
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Abstract

Objective: To evaluate the distribution and characteristics of peripheral nerve abnormalities in chronic inflammatory demyelinating polyneuropathy (CIDP) using magnetic resonance neurography (MRN) and to examine the diagnostic efficiency. Materials and Methods: Thirty-one CIDP patients and 21 controls underwent MR scans. Three-dimensional sampling perfections with application-optimized contrasts using different flip-angle evolutions and T1-/T2- weighted turbo spin-echo sequences were performed for neurography of the brachial and lumbosacral (LS) plexus and cauda equina, respectively. Clinical data and scores of the inflammatory Rasch-built overall disability scale (I-RODS) in CIDP were obtained. Results: The bilateral extracranial vagus (n = 11), trigeminal (n = 12), and intercostal nerves (n = 10) were hypertrophic. Plexus hypertrophies were observed in the brachial plexus of 19 patients (61.3%) and in the LS plexus of 25 patients (80.6%). Patterns of hypertrophy included uniform hypertrophy (17 [54.8%] brachial plexuses and 21 [67.7%] LS plexuses), and multifocal fusiform hypertrophy (2 [6.5%] brachial plexuses and 4 [12.9%] LS plexuses) was present. Enlarged and/or contrast-enhanced cauda equina was found in 3 (9.7%) and 13 (41.9%) patients, respectively. Diameters of the brachial and LS nerve roots were significantly larger in CIDP than in controls (p < 0.001). The largest AUC was obtained for the L5 nerve. There were no significant differences in the course duration, I-RODS score, or diameter between patients with and without hypertrophy. Conclusion: MRN is useful for the assessment of distribution and characteristics of the peripheral nerves in CIDP. Compared to other regions, LS plexus neurography is more sensitive for CIDP.

Keywords

Acknowledgement

We acknowledge the National Natural Science Foundation of China (Grant No. 81470076).

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