Skip to main content
Erschienen in: Neuroradiology 1/2011

01.01.2011 | Diagnostic Neuroradiology

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

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

Erschienen in: Neuroradiology | Ausgabe 1/2011

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat 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 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
2.
Zurück zum Zitat 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 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
3.
Zurück zum Zitat Latov N (2002) Diagnosis of CIDP. Neurology 59(Suppl 6):S2–S6PubMed Latov N (2002) Diagnosis of CIDP. Neurology 59(Suppl 6):S2–S6PubMed
4.
Zurück zum Zitat Koller H, Kieseier BC, Jander S, Hartung HP (2005) Chronic inflammatory demyelinating polyneuropathy. N Engl J Med 352:1343–1356CrossRefPubMed Koller H, Kieseier BC, Jander S, Hartung HP (2005) Chronic inflammatory demyelinating polyneuropathy. N Engl J Med 352:1343–1356CrossRefPubMed
5.
Zurück zum Zitat 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 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
6.
Zurück zum Zitat Bradley L, Wilhelm T, King RH, Ginsberg L, Orrell RW (2006) Brachial plexus hypertrophy in chronic inflammatory demyelinating polyradiculoneuropathy. Neuromuscul Disord 16:126–131CrossRefPubMed Bradley L, Wilhelm T, King RH, Ginsberg L, Orrell RW (2006) Brachial plexus hypertrophy in chronic inflammatory demyelinating polyradiculoneuropathy. Neuromuscul Disord 16:126–131CrossRefPubMed
7.
Zurück zum Zitat Midroni G, Tilly TN, Gray B, Vajsar J (1999) MRI of the cauda equine in CIDP: clinical correlations. J Neurol Sci 170:36–44CrossRefPubMed Midroni G, Tilly TN, Gray B, Vajsar J (1999) MRI of the cauda equine in CIDP: clinical correlations. J Neurol Sci 170:36–44CrossRefPubMed
8.
Zurück zum Zitat 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 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
9.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Bendszus M, Stoll G (2005) Technology insight: visualizing peripheral nerve injury using MRI. Nat Clin Pract Neurol 1:45–53CrossRefPubMed Bendszus M, Stoll G (2005) Technology insight: visualizing peripheral nerve injury using MRI. Nat Clin Pract Neurol 1:45–53CrossRefPubMed
14.
Zurück zum Zitat 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 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.
Zurück zum Zitat Crino B, Grossman I, Rostami A (1993) Magnetic resonance imaging of the cauda equine in chronic inflammatory demyelinating polyneuropathy. Ann Neurol 33:311–313CrossRefPubMed 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.
Zurück zum Zitat Graham I, Lantos L (2002) Greenfield’s neuropathology, 7th edition, Vol. 2. New York Oxford University Press, pp 617–620 Graham I, Lantos L (2002) Greenfield’s neuropathology, 7th edition, Vol. 2. New York Oxford University Press, pp 617–620
17.
Zurück zum Zitat 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 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.
Zurück zum Zitat Sureka J, Charian RA, Alexander M, Thomas BP (2009) MRI of brachial plexopathies. Clin Radiol 64:208–218CrossRefPubMed Sureka J, Charian RA, Alexander M, Thomas BP (2009) MRI of brachial plexopathies. Clin Radiol 64:208–218CrossRefPubMed
19.
Zurück zum Zitat 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 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
Metadaten
Titel
Brachial and lumbar plexuses in chronic inflammatory demyelinating polyradiculoneuropathy: MRI assessment including apparent diffusion coefficient
verfasst von
Yuko Adachi
Noriko Sato
Tomoko Okamoto
Masayuki Sasaki
Hirofumi Komaki
Fumio Yamashita
Jiro Kida
Tomoyuki Takahashi
Hiroshi Matsuda
Publikationsdatum
01.01.2011
Verlag
Springer-Verlag
Erschienen in
Neuroradiology / Ausgabe 1/2011
Print ISSN: 0028-3940
Elektronische ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-010-0684-7

Weitere Artikel der Ausgabe 1/2011

Neuroradiology 1/2011 Zur Ausgabe

Acknowledgment to Referees

Reviewers January 2010—November 2010

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.