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Large coverage MR neurography in CIDP: diagnostic accuracy and electrophysiological correlation
Moritz Kronlage1, Philipp Bäumer2, Kalliopi Pitarokoili3
1Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany. moritz.kronlage@med.uni-heidelberg.de.
Journal of Neurology
|June 17, 2017
Summary
Large coverage magnetic resonance neurography (MRN) shows promise for diagnosing chronic inflammatory demyelinating polyneuropathy (CIDP). Increased nerve size and signal intensity in MRN correlate with electrodiagnostic findings, particularly in proximal nerves.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Chronic inflammatory demyelinating polyneuropathy (CIDP) is a complex neurological disorder.
- Accurate diagnosis of CIDP often relies on a combination of clinical, electrophysiological, and sometimes imaging data.
- Existing imaging techniques may have limitations in comprehensively evaluating peripheral nerve involvement in CIDP.
Purpose of the Study:
- To assess the utility of large-coverage magnetic resonance neurography (MRN) in diagnosing CIDP.
- To compare MRN findings in CIDP patients with those in healthy controls.
- To investigate the correlation between MRN parameters and electrophysiological measurements in CIDP.
Main Methods:
- A prospective study involving 18 CIDP patients and 18 healthy controls.
- Standardized 3T MRN protocol including T2-weighted 3D and axial T2-weighted turbo spin-echo sequences.
- Nerve cross-sectional area (CSA) and T2-weighted signal (nT2) quantification, along with T2 relaxometry of the sciatic nerve.
- Complementary electrophysiological examinations for all participants.
Main Results:
- CIDP patients demonstrated significantly increased nerve CSA and nT2 compared to controls, predominantly in proximal locations (p < 0.05).
- Receiver operating characteristic analysis indicated high diagnostic accuracy for lumbosacral plexus CSA and sciatic nerve nT2 (AUC = 0.88).
- Nerve CSA showed stronger correlations with electrophysiological parameters (F wave latency, nerve conduction velocity) than nT2, which correlated only with sciatic nerve F wave latency.
Conclusions:
- Large-coverage MRN, particularly assessing proximal nerve CSA and nT2, can aid in diagnosing CIDP.
- Nerve CSA correlates more robustly with electrophysiological measures of demyelinating neuropathy than nT2.
- MRN serves as a valuable complementary diagnostic tool for selected CIDP cases, especially when focusing on proximal nerve segments.
