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

Abstract

Purpose: To evaluate whether 3D SHINKEI in the lumbar plexus could identify patients with chronic inflammatory demyelinating polyneuropathy (CIDP).

Materials and methods: Twenty-one patients with CIDP and 15 non-CIDP patients were studied in this retrospective study. The SNR, contrast-to-noise ratio (CNR), contrast ratio (CR) and the size of the lumbar ganglions and roots were measured. Statistical analyses were performed with Mann-Whitney U test and receiver operating characteristics (ROC) analysis.

Results: The SNRs of the ganglions and roots were larger in patients with CIDP (8.30±4.87 and 8.24±4.92) than in non-CIDP patients (4.95±2.05 and 5.08±1.97, P<0.0001, respectively). The CNRs of the ganglions and roots were larger in patients with CIDP (40.79±43.19 and 37.16±48.31) than in non-CIDP patients (25.90±10.41 and 18.37±32.83, P<0.0001, respectively). The CRs of the ganglions and roots were larger in patients with CIDP (0.74±0.13 and 0.66±0.17) than in non-CIDP patients (0.72±0.12 and 0.50±0.17, P=0.004 and P<0.0001, respectively). The sizes of the ganglions and the roots were larger in patients with CIDP (6.62±1.81mm and 5.76±3.24mm) than in non-CIDP patients (5.23±1.17mm and 4.24±1.11mm, P<0.0001, respectively). ROC analysis showed the best diagnostic performance with the CNR of the roots.

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

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