PURPOSE: The aims of this study were to assess diagnostic accuracy of diffusion tensor imaging (DTI) in chronic inflammatory demyelinating polyneuropathy (CIDP), to correlate DTI with electrophysiological parameters, and to evaluate whether radial diffusivity (RD) and axial diffusivity (AD) might serve as specific biomarkers of demyelinating and axonal pathology. MATERIALS AND METHODS: This prospective study was approved by the institutional ethics committee, and written informed consent was obtained from all participants. Magnetic resonance neurography of upper and lower extremity nerves (median, ulnar, radial, sciatic, tibial) was performed by single-shot DTI sequences at 3.0 T in 18 patients with a diagnosis of CIDP and 18 healthy controls, matched to age and sex. The scalar readout parameters nerve fractional anisotropy (FA), mean diffusivity (MD), RD, and AD were obtained after manual segmentation and postprocessing and compared between patients and controls. Diagnostic accuracy was assessed by receiver operating characteristic analysis, and cutoff values were calculated by maximizing the Youden index. All patients underwent a complementary electroneurography and correlation of electrophysiological markers and DTI parameters was analyzed and described by Pearson and Spearman coefficients. RESULTS: Nerve FA was decreased to a mean of 0.42 ± 0.08 in patients compared with 0.52 ± 0.04 in healthy controls (P < 0.001). This decrease in FA was a result of an increase of RD (P = 0.02), whereas AD did not differ between the two groups. Of all DTI parameters, FA showed best diagnostic accuracy with a receiver operating characteristic area under the curve of 0.90. Optimal cutoff for an average FA of all analyzed nerves was 0.47, yielding a sensitivity of 0.83 and a specificity of 0.94. Fractional anisotropy and RD correlated strongly with electrophysiological markers of demyelination, whereas AD did not correlate with markers of axonal neuropathy. CONCLUSIONS: Diffusion tensor imaging yields valid quantitative biomarkers in CIDP and might aid in diagnosis with high diagnostic accuracy. Fractional anisotropy and RD may serve as parameters of myelin sheath integrity, but AD is unable to reflect axonal damage in CIDP.
PURPOSE: The aims of this study were to assess diagnostic accuracy of diffusion tensor imaging (DTI) in chronic inflammatory demyelinating polyneuropathy (CIDP), to correlate DTI with electrophysiological parameters, and to evaluate whether radial diffusivity (RD) and axial diffusivity (AD) might serve as specific biomarkers of demyelinating and axonal pathology. MATERIALS AND METHODS: This prospective study was approved by the institutional ethics committee, and written informed consent was obtained from all participants. Magnetic resonance neurography of upper and lower extremity nerves (median, ulnar, radial, sciatic, tibial) was performed by single-shot DTI sequences at 3.0 T in 18 patients with a diagnosis of CIDP and 18 healthy controls, matched to age and sex. The scalar readout parameters nerve fractional anisotropy (FA), mean diffusivity (MD), RD, and AD were obtained after manual segmentation and postprocessing and compared between patients and controls. Diagnostic accuracy was assessed by receiver operating characteristic analysis, and cutoff values were calculated by maximizing the Youden index. All patients underwent a complementary electroneurography and correlation of electrophysiological markers and DTI parameters was analyzed and described by Pearson and Spearman coefficients. RESULTS: Nerve FA was decreased to a mean of 0.42 ± 0.08 in patients compared with 0.52 ± 0.04 in healthy controls (P < 0.001). This decrease in FA was a result of an increase of RD (P = 0.02), whereas AD did not differ between the two groups. Of all DTI parameters, FA showed best diagnostic accuracy with a receiver operating characteristic area under the curve of 0.90. Optimal cutoff for an average FA of all analyzed nerves was 0.47, yielding a sensitivity of 0.83 and a specificity of 0.94. Fractional anisotropy and RD correlated strongly with electrophysiological markers of demyelination, whereas AD did not correlate with markers of axonal neuropathy. CONCLUSIONS: Diffusion tensor imaging yields valid quantitative biomarkers in CIDP and might aid in diagnosis with high diagnostic accuracy. Fractional anisotropy and RD may serve as parameters of myelin sheath integrity, but AD is unable to reflect axonal damage in CIDP.
Authors: Moritz Kronlage; Véronique Schwehr; Daniel Schwarz; Tim Godel; Lorenz Uhlmann; Sabine Heiland; Martin Bendszus; Philipp Bäumer Journal: Eur Radiol Date: 2017-12-11 Impact factor: 5.315
Authors: Moritz Kronlage; Véronique Schwehr; Daniel Schwarz; Tim Godel; Inga Harting; Sabine Heiland; Martin Bendszus; Philipp Bäumer Journal: Eur Radiol Date: 2019-03-22 Impact factor: 5.315
Authors: Francisco Grandas; Manuel Desco; Francisco J Navas-Sánchez; Luis Marcos-Vidal; Daniel Martín de Blas; Alberto Fernández-Pena; Yasser Alemán-Gómez; Juan A Guzmán-de-Villoria; Julia Romero; Irene Catalina; Laura Lillo; José L Muñoz-Blanco; Andrés Ordoñez-Ugalde; Beatriz Quintáns; María-Jesús Sobrido; Susanna Carmona Journal: J Neurol Date: 2022-01-09 Impact factor: 4.849
Authors: Annina B Schmid; Jon Campbell; Samuel A Hurley; Saad Jbabdi; Jesper L Andersson; Mark Jenkinson; Neal K Bangerter; David L Bennett; Irene Tracey; Robert Frost; Stuart Clare Journal: Invest Radiol Date: 2018-12 Impact factor: 6.016
Authors: Tiffani J Mungoven; Noemi Meylakh; Kasia K Marciszewski; Vaughan G Macefield; Paul M Macey; Luke A Henderson Journal: J Headache Pain Date: 2020-05-29 Impact factor: 7.277