Evaluation of chronic inflammatory demyelinating polyneuropathy: 3D nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement imaging (3D SHINKEI)

Eur Radiol. 2017 Feb;27(2):447-453. doi: 10.1007/s00330-016-4406-3. Epub 2016 May 21.

Abstract

Objective: To evaluate the usefulness of 3D nerve-sheath signal increased with inked rest-tissue rapid acquisition of relaxation enhancement imaging (SHINKEI) in patients with chronic inflammatory demyelinating polyneuropathy (CIDP).

Methods: This institutional review board-approved retrospective study included 14 CIDP patients and nine normal subjects. The signal-to-noise ratio (SNR), contrast ratio (CR), and the size of the cervical ganglions and roots were measured by two raters.

Results: The SNRs of the ganglions and roots were larger in patients with CIDP (9.55 ± 3.87 and 9.81 ± 3.64) than in normal subjects (7.21 ± 2.42 and 5.70 ± 2.14, P < 0.0001, respectively). The CRs of the ganglions and roots were larger in patients with CIDP (0.77 ± 0.08 and 0.68 ± 0.12) than in normal subjects (0.72 ± 0.07 and 0.53 ± 0.11, P < 0.0001, respectively). The sizes of the ganglions and the roots were larger in patients with CIDP (6.44 ± 1.61 mm and 4.89 ± 1.94 mm) than in normal subjects (5.24 ± 1.02 mm and 3.39 ± 0.80 mm, P < 0.0001, respectively).

Conclusions: Patients with CIDP could be distinguished from controls on 3D SHINKEI.

Key points: • 3D SHINKEI could visualize brachial plexus with high spatial resolution. • CIDP patients showed increased SNR, CR, and the size of brachial plexus. • 3D SHINKEI could discriminate CIDP patients from normal subjects.

Keywords: Brachial plexus; Chronic inflammatory demyelinating polyneuropathy; Demyelination; Magnetic resonance imaging; Neurography.

MeSH terms

  • Adult
  • Aged
  • Brachial Plexus / diagnostic imaging
  • Female
  • Ganglia, Sympathetic / diagnostic imaging
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Observer Variation
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / diagnostic imaging*
  • Retrospective Studies
  • Signal-To-Noise Ratio
  • Young Adult