Comparison of imaging markers of nerve ultrasound and MR-neurography in a longitudinal course in chronic inflammatory demyelinating polyneuropathy.

IF 4.7 2区医学 Q1 CLINICAL NEUROLOGY

Therapeutic Advances in Neurological Disorders Pub Date : 2025-06-21 eCollection Date: 2025-01-01 DOI:10.1177/17562864251342336

Benjamin Lüling, Fabian Preisner, Jeremias Motte, Anna Lena Fisse, Thomas Grüter, Rafael Klimas, Emelie Schäfer, Annika Altenborg, Devrim Colak, Jörg Philipps, Tim Godel, Daniel Schwarz, Sabine Heiland, Min-Suk Yoon, Ralf Gold, Martin Bendszus, Moritz Kronlage, Kalliopi Pitarokoili

{"title":"Comparison of imaging markers of nerve ultrasound and MR-neurography in a longitudinal course in chronic inflammatory demyelinating polyneuropathy.","authors":"Benjamin Lüling, Fabian Preisner, Jeremias Motte, Anna Lena Fisse, Thomas Grüter, Rafael Klimas, Emelie Schäfer, Annika Altenborg, Devrim Colak, Jörg Philipps, Tim Godel, Daniel Schwarz, Sabine Heiland, Min-Suk Yoon, Ralf Gold, Martin Bendszus, Moritz Kronlage, Kalliopi Pitarokoili","doi":"10.1177/17562864251342336","DOIUrl":null,"url":null,"abstract":"Background: The novel criteria for the diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) have established imaging with nerve ultrasound (NUS) and magnetic resonance neurography (MRN) as complementary methods for CIDP diagnosis.Objectives: Our goal was to investigate the role of MRN and NUS for CIDP monitoring.Methods and design: We longitudinally examined 12 CIDP patients from 2016 to 2022 using NUS, MRN, nerve conduction studies (NCS), and clinical parameters (inflammatory neuropathy cause and treatment (INCAT)/overall disability sum score (ODSS)). NUS evaluated the cross-sectional area (CSA) of the median, ulnar, radial, tibial, fibular, and sural nerve as well as the intranerve CSA variability (INVcsa) of the tibial, fibular, ulnar, and median nerve, whereas MRN evaluated T2-weighted sequences of the fibular and tibial nerve at the popliteal fossa.Results: Five patients showed clinical improvement/stability with corresponding improved or stable NCS/NUS parameters (number of nerves with increased CSA and INVCSA). Seven deteriorating patients showed deteriorating NCS and either increasing or decreasing NUS markers possibly indicating inflammatory activity or degenerative CSA reduction. The difference ΔINCAT/ODSS2022-2016 correlated positively with NUS ΔINVCSA2022-2016 (p = 0.007, r = 0.731, n = 12) and with NUS ΔCSA2022-2016 of the tibial nerve (p = 0.0005, r = 0.865, n = 12). Further, NUS-CSA of the tibial nerve in the popliteal fossa in 2016 correlated inversely with the difference of the INCAT/ODSS score (ΔINCAT/ODSS2022-2016; r = -0.653; p = 0.033; n = 11). Finally, the Bland-Altman analyses for the tibial and fibular nerve showed a bias of -1.903 and 2.195 mm2 (bias = NUS-CSA - MRN-CSA) accordingly revealing a difference between MRN and NUS measurements for deeper nerves.Conclusion: CSA and INVCSA of the tibial and fibular nerve can be used for monitoring in CIDP, and increased CSA of the tibial nerve is a good prognostic marker. MRN is more reliable for evaluating inflammation in proximal leg nerve segments.","PeriodicalId":22980,"journal":{"name":"Therapeutic Advances in Neurological Disorders","volume":"18 ","pages":"17562864251342336"},"PeriodicalIF":4.7000,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182616/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Neurological Disorders","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17562864251342336","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The novel criteria for the diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) have established imaging with nerve ultrasound (NUS) and magnetic resonance neurography (MRN) as complementary methods for CIDP diagnosis.

Objectives: Our goal was to investigate the role of MRN and NUS for CIDP monitoring.

Methods and design: We longitudinally examined 12 CIDP patients from 2016 to 2022 using NUS, MRN, nerve conduction studies (NCS), and clinical parameters (inflammatory neuropathy cause and treatment (INCAT)/overall disability sum score (ODSS)). NUS evaluated the cross-sectional area (CSA) of the median, ulnar, radial, tibial, fibular, and sural nerve as well as the intranerve CSA variability (INV_csa) of the tibial, fibular, ulnar, and median nerve, whereas MRN evaluated T2-weighted sequences of the fibular and tibial nerve at the popliteal fossa.

Results: Five patients showed clinical improvement/stability with corresponding improved or stable NCS/NUS parameters (number of nerves with increased CSA and INV_CSA). Seven deteriorating patients showed deteriorating NCS and either increasing or decreasing NUS markers possibly indicating inflammatory activity or degenerative CSA reduction. The difference ΔINCAT/ODSS_2022-2016 correlated positively with NUS ΔINV_CSA2022-2016 (p = 0.007, r = 0.731, n = 12) and with NUS ΔCSA_2022-2016 of the tibial nerve (p = 0.0005, r = 0.865, n = 12). Further, NUS-CSA of the tibial nerve in the popliteal fossa in 2016 correlated inversely with the difference of the INCAT/ODSS score (ΔINCAT/ODSS_2022-2016; r = -0.653; p = 0.033; n = 11). Finally, the Bland-Altman analyses for the tibial and fibular nerve showed a bias of -1.903 and 2.195 mm² (bias = NUS-CSA - MRN-CSA) accordingly revealing a difference between MRN and NUS measurements for deeper nerves.

Conclusion: CSA and INV_CSA of the tibial and fibular nerve can be used for monitoring in CIDP, and increased CSA of the tibial nerve is a good prognostic marker. MRN is more reliable for evaluating inflammation in proximal leg nerve segments.

查看原文本刊更多论文

慢性炎性脱髓鞘性多神经病变纵向病程的神经超声与核磁共振影像学指标比较。

背景：慢性炎症性脱髓鞘性多神经病变（CIDP）的新诊断标准建立了神经超声（NUS）和磁共振神经成像（MRN）作为CIDP诊断的补充方法。目的：我们的目的是探讨MRN和NUS在CIDP监测中的作用。方法和设计：我们使用NUS、MRN、神经传导研究（NCS）和临床参数(炎症性神经病变病因和治疗（INCAT)/总残疾积分（ODSS））对2016年至2022年12例CIDP患者进行了纵向检查。NUS评估正中神经、尺神经、桡神经、胫骨神经、腓骨神经和腓神经的横截面积（CSA）以及胫骨神经、腓骨神经、尺神经和正中神经的神经内CSA变异性（INVcsa），而MRN评估腘窝处腓骨神经和胫神经的t2加权序列。结果：5例患者临床改善/稳定，NCS/NUS参数（CSA和INVCSA增加的神经数）相应改善或稳定。7例恶化的患者NCS恶化，NUS标记物升高或降低，可能表明炎症活动或退行性CSA减少。差异ΔINCAT/ODSS2022-2016与NUS ΔINVCSA2022-2016 （p = 0.007, r = 0.731, n = 12）和胫骨神经NUS ΔCSA2022-2016 （p = 0.0005, r = 0.865, n = 12）呈正相关。此外，2016年腘窝胫神经的NUS-CSA与INCAT/ODSS评分的差异呈负相关(ΔINCAT/ODSS2022-2016；r = -0.653；p = 0.033；n = 11)。最后，胫骨和腓骨神经的Bland-Altman分析显示偏差为-1.903和2.195 mm2（偏差= NUS- csa - MRN- csa），从而揭示了MRN和NUS测量深层神经之间的差异。结论：胫腓骨神经CSA和INVCSA可作为cdp的监测指标，胫腓骨神经CSA升高是一个很好的预后指标。MRN在评估腿近端神经段炎症方面更为可靠。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Therapeutic Advances in Neurological Disorders CLINICAL NEUROLOGY-

CiteScore

8.30

自引率

1.70%

发文量

审稿时长

15 weeks

期刊介绍： Therapeutic Advances in Neurological Disorders is a peer-reviewed, open access journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of neurology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in neurology, providing a forum in print and online for publishing the highest quality articles in this area.