Quantitative Neuromuscular MRI in CIDP Patients: Interest of a Multiparametric Approach

Area of Science:

• Neurology
• Radiology
• Biomarkers

Background:

• Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) presents with diverse clinical symptoms and lacks established imaging biomarkers.
• Individual quantitative MRI (qMRI) parameters have been explored, but their diagnostic and clinical significance in CIDP remains unclear.

Purpose of the Study:

• To investigate the diagnostic and clinical relevance of multiple qMRI parameters in differentiating CIDP from healthy controls and variant transthyretin amyloid neuropathy (vATTR).
• To assess the correlation between qMRI findings and clinical/electrophysiological measures in CIDP.

Main Methods:

• Prospective enrollment of 28 CIDP patients, 13 healthy controls, and 17 vATTR patients.
• 1.5T qMRI of nerves and muscles, extracting parameters like volume, MTR, fat fraction, and T2 relaxation time.
• Correlation analysis of imaging parameters with clinical (ONLS, RODS, MRC) and electrophysiological (MUNIX) data.

Main Results:

• CIDP patients exhibited increased nerve volume and decreased MTR compared to controls (p < 0.005).
• Muscle abnormalities in CIDP included increased fat fraction and decreased MTR in leg muscles.
• MTR demonstrated strong correlations with disability scores and MUNIX, while nerve volume was a sensitive diagnostic marker.

Conclusions:

• Nerve volume and MTR are promising quantitative MRI biomarkers for CIDP diagnosis and assessing disease burden.
• A multiparametric qMRI approach holds potential for enhancing diagnosis and monitoring of CIDP.