Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Eur J Neurol. 2021 Aug;28(8):2716-2726. doi: 10.1111/ene.14896. Epub 2021 May 27.
The immunological pathophysiologies of chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN) differ considerably, but neither has been elucidated completely. Quantitative magnetic resonance imaging (MRI) techniques such as diffusion tensor imaging, T2 mapping, and fat fraction analysis may indicate in vivo pathophysiological changes in nerve architecture. Our study aimed to systematically study nerve architecture of the brachial plexus in patients with CIDP, MMN, motor neuron disease (MND) and healthy controls using these quantitative MRI techniques.
We enrolled patients with CIDP (n = 47), MMN (n = 29), MND (n = 40) and healthy controls (n = 10). All patients underwent MRI of the brachial plexus and we obtained diffusion parameters, T2 relaxation times and fat fraction using an automated processing pipeline. We compared these parameters between groups using a univariate general linear model.
Fractional anisotropy was lower in patients with CIDP compared to healthy controls (p < 0.001), patients with MND (p = 0.010) and MMN (p < 0.001). Radial diffusivity was higher in patients with CIDP compared to healthy controls (p = 0.015) and patients with MND (p = 0.001) and MMN (p < 0.001). T2 relaxation time was elevated in patients with CIDP compared to patients with MND (p = 0.023). Fat fraction was lower in patients with CIDP and MMN compared to patients with MND (both p < 0.001).
Our results show that quantitative MRI parameters differ between CIDP, MMN and MND, which may reflect differences in underlying pathophysiological mechanisms.
慢性炎症性脱髓鞘性多发性神经病（CIDP）和多发性运动神经病（MMN）的免疫学发病机制有很大的不同，但都尚未完全阐明。定量磁共振成像（MRI）技术，如弥散张量成像、T2 映射和脂肪分数分析，可能可以显示神经结构的体内病理生理变化。我们的研究旨在使用这些定量 MRI 技术系统地研究 CIDP、MMN、运动神经元病（MND）患者和健康对照者的臂丛神经结构。
我们纳入了 47 例 CIDP 患者、29 例 MMN 患者、40 例 MND 患者和 10 例健康对照者。所有患者均接受了臂丛 MRI 检查，我们使用自动处理管道获得了弥散参数、T2 弛豫时间和脂肪分数。我们使用单变量一般线性模型比较了这些参数在各组之间的差异。
与健康对照组相比，CIDP 患者的各向异性分数较低（p<0.001），与 MND 患者（p=0.010）和 MMN 患者（p<0.001）相比也较低。与健康对照组（p=0.015）和 MND 患者（p=0.001）和 MMN 患者（p<0.001）相比，CIDP 患者的径向弥散度较高。与 MND 患者相比，CIDP 患者的 T2 弛豫时间升高（p=0.023）。与 MND 患者相比，CIDP 患者和 MMN 患者的脂肪分数较低（均 p<0.001）。
我们的结果表明，CIDP、MMN 和 MND 之间的定量 MRI 参数不同，这可能反映了潜在病理生理机制的差异。
