Highlights
- •MR microneurography can visualize some of the microscopic components of nerves.
- •CIDP patients show peripheral nerve enlargement distally at the tibial nerves.
- •This results from the net increase of the area of the nerve's fascicles.
- •The epineurial area as well as T2 and PD are not significantly modified.
Abstract
Objective
In this study we investigated the potential of magnetic resonance (MR) micro-neurography
to detect morphological and relaxometric changes in distal tibial nerves in patients
affected with chronic inflammatory demyelinating polyneuropathy (CIDP), and their
associations with clinical and electrophysiological features.
Materials and methods
10 subjects affected with CIDP and 10 healthy subjects were examined. Multiple MR
parameters, including the number of fascicles (N), fascicles diameter (FD), total
fascicles area (FA), epineurium area (EA), total nerve area (NA), fascicles to nerve
ratio (FNR) and quantitative T2 and proton density (PD) were investigated on high
resolution MR images of the distal tibial nerve. Those parameters were correlated
with clinical scores, age of onset, disease duration and electrophysiologic data.
Results
Median NA and FA were significantly increased in the CIDP population (median values
for NA in cm2 in CIDP: 0.185; controls: 0.135; p: 0.028; for FA in CIDP 0.136; controls 0.094;
p: 0.021). There was no correlation between the parameters investigated and clinical
or electrophysiologic features.
Conclusion
MR microneurography can detect increased total nerve and fascicle area in distal tibial
nerves in CIDP and may be useful for diagnosing CIDP.
Keywords
Abbreviations:
MRI (magnetic resonance imaging), CIDP (chronic inflammatory demyelinating polyneuropathy), N (number of fascicles), FD (fascicles diameter), FA (total fascicles area), EA (epineurium area), NA (total nerve area), FNR (fascicles to nerve ratio), PD (proton density), NCS (nerve conduction studies), MRC-APF (Medical Research Council muscle strength score for Ankle Plantar Flexion of the imaged side), MRC-LL (Medical Research Council muscle strength sum score for the Lower Limbs), INCAT-LL (Inflammatory Neuropathy Cause and Treatment score for the Lower Limbs), ISS-LL (INCAT sensory score for the Lower Limbs)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 11, 2019
Accepted:
March 4,
2019
Received in revised form:
February 10,
2019
Received:
September 12,
2018
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
