Quantitative assessment of brachial plexus MRI for the diagnosis of chronic inflammatory neuropathies
- PDF / 2,007,908 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 25 Downloads / 157 Views
ORIGINAL COMMUNICATION
Quantitative assessment of brachial plexus MRI for the diagnosis of chronic inflammatory neuropathies Marieke H. J. van Rosmalen1,2 · H. Stephan Goedee1 · Anouk van der Gijp2 · Theo D. Witkamp2 · Ruben P. A. van Eijk1,3 · Fay‑Lynn Asselman1 · Leonard H. van den Berg1 · Stefano Mandija4,5 · Martijn Froeling2 · Jeroen Hendrikse2 · W. Ludo van der Pol1 Received: 11 August 2020 / Revised: 14 September 2020 / Accepted: 15 September 2020 © The Author(s) 2020
Abstract Objective This study aimed at developing a quantitative approach to assess abnormalities on MRI of the brachial plexus and the cervical roots in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy (MMN) and to evaluate interrater reliability and its diagnostic value. Methods We performed a cross-sectional study in 50 patients with CIDP, 31 with MMN and 42 disease controls. We systematically measured cervical nerve root sizes on MRI bilaterally (C5, C6, C7) in the coronal [diameter (mm)] and sagittal planes [area (mm2)], next to the ganglion (G0) and 1 cm distal from the ganglion (G1). We determined their diagnostic value using a multivariate binary logistic model and ROC analysis. In addition, we evaluated intra- and interrater reliability. Results Nerve root size was larger in patients with CIDP and MMN compared to controls at all predetermined anatomical sites. We found that nerve root diameters in the coronal plane had optimal reliability (intrarater ICC 0.55–0.87; interrater ICC 0.65–0.90). AUC was 0.78 (95% CI 0.69–0.87) for measurements at G0 and 0.81 (95% CI 0.72–0.91) for measurements at G1. Importantly, our quantitative assessment of brachial plexus MRI identified an additional 10% of patients that showed response to treatment, but were missed by nerve conduction (NCS) and nerve ultrasound studies. Conclusion Our study showed that a quantitative assessment of brachial plexus MRI is reliable. MRI can serve as an important additional diagnostic tool to identify treatment-responsive patients, complementary to NCS and nerve ultrasound. Keywords Magnetic resonance imaging · Brachial plexus · Chronic inflammatory demyelinating polyneuropathy · Multifocal motor neuropathy · Diagnostic value Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00415-020-10232-8) contains supplementary material, which is available to authorized users. * H. Stephan Goedee [email protected] 1
Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
2
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
3
Biostatistics and Research Support, Julius Centre for Healthy Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
4
Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
5
Computational Imaging Group for MR Diagnostic and Therapy, University Medical Center Utrecht, Utrech
Data Loading...
