Kerasnoudis A, Pitarokoili K, Behrendt V, Gold R, Yoon M-S
Department of Neurology, St. Josef Hospital, Ruhr University of Bochum, Germany.
Clin Neurophysiol. 2014 Mar;125(3):635-41. doi: 10.1016/j.clinph.2013.08.014. Epub 2013 Sep 23.
Aim of this study was to develop and evaluate the applicability of an ultrasound score (Bochum ultrasound score - BUS) in distinguishing chronic (CIDP) from acute inflammatory demyelinating polyneuropathy (AIDP).
Step 1: For the development of BUS 75 healthy-controls, 20 CIDP, 20 AIDP patients underwent US 4.55 ± 3.5 and 3.4 ± 2.91 years, respectively after onset. After comparing the distribution pattern and frequency of pathological US changes between the two study groups, we developed BUS, summarizing the cross sectional area (CSA) of: (1) the ulnar nerve in Guyons' canal, (2) the ulnar nerve in upper-arm, (3) the radial nerve in spiral groove, (4) the sural nerve between the gastrocnemius muscle. Step 2: The BUS underwent blinded evaluation in further 10 CIDP, 21 AIDP patients 3.8 ± 2.7 and 2.3 ± 1.5 years, respectively after onset. Step 3: The BUS underwent blinded, prospective evaluation in 8 patients with acute/subacute polyradiculoneuropathy (5 CIDP, 3 AIDP) 2.6 ± 1.8 weeks after onset.
The BUS showed a sensitivity of 90% and specificity of 90.4% (positive predictive value, PPV=81.8%; negative predictive value, NPV=95%) in distinguishing CIDP from AIDP, when they showed no differences in disease duration (p=0.0551).In addition, the BUS distinguished subacute-CIDP from AIDP with a sensitivity of 80%, specificity of 100% (PPV=100%, NPV=75%).
The BUS seems to allow a reliable distinction of CIDP from AIDP.
The BUS may be helpful in distinguishing subacute-CIDP from AIDP.
本研究旨在开发并评估一种超声评分（波鸿超声评分 - BUS）在区分慢性炎症性脱髓鞘性多发性神经病（CIDP）与急性炎症性脱髓鞘性多发性神经病（AIDP）方面的适用性。
步骤1：为开发BUS，75名健康对照者、20名CIDP患者和20名AIDP患者在发病后分别于4.55±3.5年和3.4±2.91年接受了超声检查。在比较两个研究组之间病理性超声改变的分布模式和频率后，我们开发了BUS，总结了以下部位的横截面积（CSA）：（1）Guyon管内的尺神经；（2）上臂的尺神经；（3）螺旋沟内的桡神经；（4）腓肠肌之间的腓肠神经。步骤2：对另外10名CIDP患者和21名AIDP患者在发病后分别于3.8±2.7年和2.3±1.5年进行了BUS的盲法评估。步骤3：对8例急性/亚急性多发性神经根神经病患者（5例CIDP，3例AIDP）在发病后2.6±1.8周进行了BUS的盲法前瞻性评估。
当CIDP和AIDP在病程上无差异时（p = 0.0551），BUS在区分CIDP与AIDP方面显示出90%的敏感性和90.4%的特异性（阳性预测值，PPV = 81.8%；阴性预测值，NPV = 95%）。此外，BUS区分亚急性CIDP与AIDP的敏感性为80%，特异性为100%（PPV = 100%，NPV = 75%）。
BUS似乎能够可靠地区分CIDP与AIDP。
BUS可能有助于区分亚急性CIDP与AIDP。
