Tozza Stefano, Cassano Emanuele, Erra Carmen, Muto Mario, Habetswallner Francesco, Manganelli Fiore
Department of Neuroscience, Reproductive and Odontostomatological Science, University of Naples Federico II, Naples, Italy.
Clinical Neurophysiology Unit, Cardarelli Hospital, Naples, Italy.
Eur J Neurol. 2025 Jun;32(6):e70226. doi: 10.1111/ene.70226.
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a treatable immune-mediated neuropathy with a relapsing-remitting course and symmetrical proximal and distal weakness. Diagnosis relies on nerve conduction studies (NCS) to detect demyelination but can be difficult in atypical cases. In such instances, nerve ultrasound (US) and MRI of the brachial and lumbosacral plexuses help improve diagnostic accuracy and guide treatment. This review examines the role of imaging in CIDP, focusing on its contribution to diagnosis, prognosis, and follow-up.
A total of 183 articles were identified in the PubMed database using the search terms: "CIDP AND imaging," "CIDP AND ULTRASOUND," and "CIDP AND MRI." Based on predefined inclusion criteria, 106 articles were selected for review (63 related to US and 43 to MRI). From each included study, data were extracted on the study population, imaging protocols used, outcome measures applied, and main findings relevant to the review's aim.
The most used ultrasound and MRI protocols, along with their associated outcome measures, are discussed. Furthermore, the roles of each imaging modality in diagnosis, prognosis, and follow-up are analysed.
Although NCS remain the primary instrumental test for the diagnosis of CIDP, US and MRI can be valuable adjuncts in cases with diagnostic uncertainty. Additionally, these imaging modalities may be more useful than NCS in prognostic evaluation, helping in predict treatment response and monitoring subclinical disease activity.
慢性炎症性脱髓鞘性多发性神经病（CIDP）是一种可治疗的免疫介导性神经病，病程呈复发-缓解型，伴有对称性近端和远端肌无力。诊断依赖于神经传导研究（NCS）以检测脱髓鞘，但在非典型病例中可能会遇到困难。在这种情况下，臂丛和腰骶丛的神经超声（US）和磁共振成像（MRI）有助于提高诊断准确性并指导治疗。本综述探讨了影像学在CIDP中的作用，重点关注其对诊断、预后和随访的贡献。
在PubMed数据库中使用搜索词“CIDP AND imaging”“CIDP AND ULTRASOUND”和“CIDP AND MRI”共识别出183篇文章。根据预先定义的纳入标准，选择106篇文章进行综述（63篇与超声相关，43篇与MRI相关）。从每项纳入研究中，提取关于研究人群、所使用的成像方案、应用的结局指标以及与综述目的相关的主要发现的数据。
讨论了最常用的超声和MRI方案及其相关的结局指标。此外，分析了每种成像方式在诊断、预后和随访中的作用。
尽管NCS仍然是CIDP诊断的主要仪器检查，但在诊断不确定的病例中，超声和MRI可以作为有价值的辅助手段。此外，这些成像方式在预后评估中可能比NCS更有用，有助于预测治疗反应和监测亚临床疾病活动。
