Whole-body magnetic resonance neurography in patients with chronic inflammatory demyelinating polyneuropathy.

Autor: Fathi D; Section of Neurology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada., Naraghi A; Toronto Joint Department of Medical Imaging, Toronto, Ontario, Canada.; Sinai Health System, University Health Network and Women's College Hospital, Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., White LM; Toronto Joint Department of Medical Imaging, Toronto, Ontario, Canada.; Sinai Health System, University Health Network and Women's College Hospital, Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., Dodig D; Division of Neurology, Department of Medicine, University of Toronto/Toronto Western Hospital, Toronto, Ontario, Canada., Barnett-Tapia C; Division of Neurology, University Health Network, University of Toronto, Toronto, Ontario, Canada., Breiner A; Division of Neurology, Department of Medicine, The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada., Bril V; Division of Neurology, University Health Network, University of Toronto, Toronto, Ontario, Canada., Katzberg HD; Division of Neurology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Muscle & nerve [Muscle Nerve] 2024 Jul; Vol. 70 (1), pp. 101-110. Date of Electronic Publication: 2024 May 03.
DOI: 10.1002/mus.28098
Abstrakt: Introduction/aims: Whole-body magnetic resonance neurography (MRN) is an imaging modality that shows peripheral nerve signal change in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). We aimed to explore the diagnostic potential of whole-body MRN and its potential as a monitoring tool after immunotherapy in treatment-naïve CIDP patients.
Methods: Whole-body MRN using coronal 3-dimensional short tau inversion recovery (STIR) sampling perfection with application-optimized contrasts by using different flip angle evolution (SPACE) techniques was performed in patients being investigated for CIDP and in healthy controls. Baseline clinical neuropathy scales and electrophysiologic parameters were collected, and MRN findings were compared before and after CIDP treatment.
Results: We found highly concordant symmetrical thickening and increased T2 signal intensities in the brachial/lumbosacral plexus, femoral, or sciatic nerves in five of the eight patients with a final diagnosis of CIDP and none of the healthy controls. There were no treatment-related imaging changes in five patients with CIDP who completed a follow-up study. Diffuse, symmetrical thickening, and increased T2 signal in root, plexus, and peripheral nerves were found in two patients ultimately excluded due to a diagnosis of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes (POEMS) syndrome in addition to signal changes in the muscles, bony lesions, organomegaly, and lymphadenopathy.
Discussion: Whole-body MRN imaging shows promise in detecting abnormalities in proximal nerve segments in patients with CIDP. Future studies evaluating the role of MRN in assessing treatment response should consider follow-up scans after treatment durations of more than 4 months.
(© 2024 The Authors. Muscle & Nerve published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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