Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China.
Korean J Radiol. 2020 Apr;21(4):483-493. doi: 10.3348/kjr.2019.0739.
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.
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.
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 ( < 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.
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.
使用磁共振神经成像（MRN）评估慢性炎症性脱髓鞘性多发性神经病（CIDP）中周围神经异常的分布和特征，并检验其诊断效率。
31 例 CIDP 患者和 21 例对照者接受了 MR 扫描。分别对臂丛和腰骶丛（LS）以及马尾进行三维采样完美，应用不同翻转角演化和 T1-/T2-加权涡轮自旋回波序列进行应用优化对比的神经成像。获得 CIDP 患者的临床数据和炎症 Rasch 构建整体残疾评分（I-RODS）评分。
11 例双侧颅外迷走神经（n = 11）、12 例三叉神经（n = 12）和 10 例肋间神经（n = 10）呈肥大性改变。19 例患者（61.3%）出现臂丛神经丛肥大，25 例患者（80.6%）出现 LS 神经丛肥大。肥大模式包括均匀性肥大（17 个臂丛和 21 个 LS 神经丛，54.8%）和多灶性梭形肥大（2 个臂丛和 4 个 LS 神经丛，6.5%）。3 例（9.7%）和 13 例（41.9%）患者分别发现增大和/或对比增强的马尾。CIDP 患者的臂丛和 LS 神经根直径明显大于对照组（<0.001）。L5 神经根的 AUC 最大。有肥大和无肥大患者的病程持续时间、I-RODS 评分或直径无显著差异。
MRN 可用于评估 CIDP 中周围神经的分布和特征。与其他区域相比，LS 神经丛神经成像对 CIDP 更敏感。
