Stefanie Schreiber1,2,3, Frank Schreiber1,2, Alica Peter1, Eser Isler1,2, Marc Dörner4, Hans-Jochen Heinze1,2,3,5, Suanne Petri6, Claus Tempelmann1, Peter J Nestor7,8, Alexander Grimm9, Stefan Vielhaber1,2,3. 1. Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany. 2. German Center for Neurodegenerative Diseases (DZNE) within the Helmholtz Association, Magdeburg, Germany. 3. Center for Behavioral Brain Sciences, Magdeburg, Germany. 4. Department of Neurodegenerative Diseases & Geropsychiatry, University of Bonn, Bonn, Germany. 5. Leibniz Institute for Neurobiology, Magdeburg, Germany. 6. Department of Neurology, Hannover Medical School, Hannover, Germany. 7. Queensland Brain Institute, The University of Queensland, Brisbane, Australia. 8. Mater Hospital, Brisbane, Australia. 9. Department of Neurology, University Hospital Tuebingen, Tuebingen, Germany.
Abstract
BACKGROUND: We present one patient with an initial diagnosis of Guillain-Barré syndrome (GBS) and one with Charcot-Marie-Tooth disease (CMT) type 1A. METHODS: Both patients underwent ankle tibial nerve fusion-imaging of high-resolution ultrasound (HRUS) with 7T MR neurography (MRN). RESULTS: In GBS, the nerve was enlarged, T2-hyperintense, and showed increased vascularization 21 months after symptom onset. In CMT1A, the enlarged nerve was T2-isointense with normal endoneurial blood flow. CONCLUSIONS: We demonstrate the utility of 7T-MRN-HRUS-fusion-imaging. In GBS, there was evidence of ongoing inflammation resulting in a changed diagnosis to acute-onset chronic demyelinating polyradiculoneuropathy and maintenance of immunotherapy. By MRN-HRUS-fusion, patients with presumed peripheral axonal degeneration could be shown to display imaging markers associated with peripheral nervous system inflammation. Thus, more accurate identification of a treatable inflammatory component may become possible.
BACKGROUND: We present one patient with an initial diagnosis of Guillain-Barré syndrome (GBS) and one with Charcot-Marie-Tooth disease (CMT) type 1A. METHODS: Both patients underwent ankle tibial nerve fusion-imaging of high-resolution ultrasound (HRUS) with 7T MR neurography (MRN). RESULTS: In GBS, the nerve was enlarged, T2-hyperintense, and showed increased vascularization 21 months after symptom onset. In CMT1A, the enlarged nerve was T2-isointense with normal endoneurial blood flow. CONCLUSIONS: We demonstrate the utility of 7T-MRN-HRUS-fusion-imaging. In GBS, there was evidence of ongoing inflammation resulting in a changed diagnosis to acute-onset chronic demyelinating polyradiculoneuropathy and maintenance of immunotherapy. By MRN-HRUS-fusion, patients with presumed peripheral axonal degeneration could be shown to display imaging markers associated with peripheral nervous system inflammation. Thus, more accurate identification of a treatable inflammatory component may become possible.
Authors: Marc Dörner; Mihai Ceanga; Frank Schreiber; Jan-Hendrik Stahl; Cornelius Kronlage; Julia Wittlinger; Magdalena Kramer; Sophia Willikens; Stefanie Schreiber; Alexander Grimm; Natalie Winter Journal: Diagnostics (Basel) Date: 2021-02-09