Top

Published in:

01-01-2011 | Diagnostic Neuroradiology

Brachial and lumbar plexuses in chronic inflammatory demyelinating polyradiculoneuropathy: MRI assessment including apparent diffusion coefficient

Authors: Yuko Adachi, Noriko Sato, Tomoko Okamoto, Masayuki Sasaki, Hirofumi Komaki, Fumio Yamashita, Jiro Kida, Tomoyuki Takahashi, Hiroshi Matsuda

Published in: Neuroradiology | Issue 1/2011

Abstract

Introduction

Our purpose was to clarify the magnetic resonance (MR) imaging characteristics of the brachial and lumbar plexuses in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) using various kinds of sequences, including diffusion-weighted images (DWI).

Methods

We evaluated the MR imaging findings for lumbar and/or brachial nerve plexuses in 13 CIDP patients and 11 normal volunteers. The nerve swelling was evaluated in comparison with normal controls by coronal short tau inversion recovery (STIR), and signal abnormalities were evaluated by coronal STIR, T1-weighted images, and DWIs. The degrees of contrast enhancement and apparent diffusion coefficient (ADC) values of the plexus were also assessed.

Results

In the patient group, diffuse enlargement and abnormally high signals were detected in 16 out of 24 plexuses (66.7%) on STIR, a slightly high signal was detected in 12 of 24 plexuses (50%) on T1-weighted images, and a high-intensity signal was detected in 10 of 18 plexuses (55.6%) on DWIs with high ADC values. Contrast enhancement of the plexuses was revealed in 6 of 19 plexuses (31.6%) and was mild in all cases. There were statistically significant differences between the ADC values of patients with either swelling or abnormal signals and those of both normal volunteers and patients without neither swelling nor abnormal signals. There were no relationships between MR imaging and any clinical findings.

Conclusion

STIR is sufficient to assist clinicians in diagnosing CIDP. T1-weighted images and DWIs seemed useful for speculating about the pathological changes in swollen plexuses in CIDP patients.

Hahn A, Hartung H, Dick P (2005) Chronic inflammatory demyelinating polyradiculoneuropathy. In: Dick P (ed) Peripheral neuropathy, vol 2, 4th ed. Elsevier, Philadelphia, pp 2221–2253

Joint Task Force of the EFNS and the PNS (2005) European Federation of Neurological Societies/Peripheral Nerve Society Guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. J Peripher Nerv Syst 10:220–228CrossRef

Latov N (2002) Diagnosis of CIDP. Neurology 59(Suppl 6):S2–S6PubMed

Koller H, Kieseier BC, Jander S, Hartung HP (2005) Chronic inflammatory demyelinating polyneuropathy. N Engl J Med 352:1343–1356CrossRefPubMed

Eurelings M, Notermans NC, Franssen H, Van Es H, Ramos H, Wokke J, Van Den Berg H (2001) MRI of the brachial plexus in polyneuropathy associated with monoclonal gammopathy. Muscle Nerve 24:1312–1318CrossRefPubMed

Bradley L, Wilhelm T, King RH, Ginsberg L, Orrell RW (2006) Brachial plexus hypertrophy in chronic inflammatory demyelinating polyradiculoneuropathy. Neuromuscul Disord 16:126–131CrossRefPubMed

Midroni G, Tilly TN, Gray B, Vajsar J (1999) MRI of the cauda equine in CIDP: clinical correlations. J Neurol Sci 170:36–44CrossRefPubMed

Duggins A, McLeod J, Pollard J, Davies L, Yang F, Thompson EO, Soper JR (1999) Spinal root and plexus hypertrophy in chronic inflammatory demyelinating polyneuropathy. Brain 122:1383–1390CrossRefPubMed

Kuwabara S, Nakajima M, Matsuda S, Hattori T (1997) Magnetic resonance imaging at the demyelinative foci in chronic inflammatory demyelinating polyneuropathy. Neurology 48:874–877PubMed

10.

Tsuchiya K, Imai M, Tateishi H, Nitatori T, Fujikawa A, Takemoto S (2007) Neurography of the spinal nerve roots by diffusion tensor scanning applying motion-probing gradients in six directions. Magn Reson Med Sci 6:1–5CrossRefPubMed

11.

Tsuchiya K, Honya K, Yoshida M, Nitatori T (2008) Demonstration of spinal cord and nerve root abnormalities by diffusion neurography. J Comput Assist Tomogr 32:286–290CrossRefPubMed

12.

Takahara T, Hendrikse J, Yamashita T, Mali W, Kwee T, Imai Y, Luijten P (2008) Diffusion-weighted MR neurography of the brachial plexus: feasibility study. Radiology 249(2):653–660CrossRefPubMed

13.

Bendszus M, Stoll G (2005) Technology insight: visualizing peripheral nerve injury using MRI. Nat Clin Pract Neurol 1:45–53CrossRefPubMed

14.

Kababci N, Gurses B, Firat Z. Bayram A, Ulug A, Kovanlikaya A (2007) Diffusion tensor imaging and tractography of median nerve: Normative diffusion values. AJR 189:923–927CrossRef

15.

Crino B, Grossman I, Rostami A (1993) Magnetic resonance imaging of the cauda equine in chronic inflammatory demyelinating polyneuropathy. Ann Neurol 33:311–313CrossRefPubMed

16.

Graham I, Lantos L (2002) Greenfield’s neuropathology, 7th edition, Vol. 2. New York Oxford University Press, pp 617–620

17.

Naba I, Yoshikawa H, Sakoda S, Itabe H, Suzuki H, Kodama T, Yanagihara T (2000) Onion-bulb formation after a single compression injury in the macrophage scavenger receptor knockout mice. Exp Neurol 166:83–89CrossRefPubMed

18.

Sureka J, Charian RA, Alexander M, Thomas BP (2009) MRI of brachial plexopathies. Clin Radiol 64:208–218CrossRefPubMed

19.

Van Es H, Van den Berg L, Franssen H et al (1997) Magnetic resonance imaging of the brachial plexus in patients with multifocal motor neuropathy. Neurology 48(5):1218–1224PubMed

Title: Brachial and lumbar plexuses in chronic inflammatory demyelinating polyradiculoneuropathy: MRI assessment including apparent diffusion coefficient
Authors: Yuko Adachi
Noriko Sato
Tomoko Okamoto
Masayuki Sasaki
Hirofumi Komaki
Fumio Yamashita
Jiro Kida
Tomoyuki Takahashi
Hiroshi Matsuda
Publication date: 01-01-2011
Publisher: Springer-Verlag
Published in: Neuroradiology / Issue 1/2011
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-010-0684-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Brachial and lumbar plexuses in chronic inflammatory demyelinating polyradiculoneuropathy: MRI assessment including apparent diffusion coefficient

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2011

Decreased CSF-flow artefacts in T2 imaging of the cervical spine with periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER/BLADE)

Measurements of the normal fetal brain at gestation weeks 17 to 23: a MRI study

Reviewers January 2010—November 2010

Early fatal hemorrhage after endovascular cerebral aneurysm treatment with a flow diverter (SILK-Stent)

Postprocedural CT for perivertebral cement leakage in percutaneous vertebroplasty is not necessary—results from VERTOS II

Can diffusion tensor metrics help in preoperative grading of diffusely infiltrating astrocytomas? A retrospective study of 36 cases