Contribution of plexus MRI in the diagnosis of atypical chronic inflammatory demyelinating polyneuropathies.

Details

Serval ID
serval:BIB_907B2D360BD0
Type
Article: article from journal or magazin.
Collection
Publications
Title
Contribution of plexus MRI in the diagnosis of atypical chronic inflammatory demyelinating polyneuropathies.
Journal
Journal of the neurological sciences
Author(s)
Lozeron P., Lacour M.C., Vandendries C., Théaudin M., Cauquil C., Denier C., Lacroix C., Adams D.
ISSN
1878-5883 (Electronic)
ISSN-L
0022-510X
Publication state
Published
Issued date
15/01/2016
Peer-reviewed
Oui
Volume
360
Pages
170-175
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Nerve enlargement has early been recognized in CIDP and plexus MRI hypertrophy has been reported in typical CIDP cases. Our aim is to determine plexus MRI value in the diagnosis of CIDP with an initial atypical presentation, which, up to now, has not been demonstrated. Retrospective study of 33 consecutive patients suspected of CIDP. Plexus MRI was performed on the most affected territory (brachial or lumbar). Were assessed: plexus trophicity, T2-STIR signal intensity and gadolinium enhancement. Final CIDP diagnosis was made after comprehensive workup. A histo-radiological correlation was performed. Final CIDP diagnosis was made in 25 (76%) including 21 with initial atypical clinical presentation. Eleven CIDP patients (52%) with initial atypical clinical presentation had abnormal plexus MRI including 9 suggestive of CIDP (43%) and none of the patients with an alternative diagnosis. Hypertrophy of the proximal plexus and/or extraforaminal roots was found in 8 cases and Gadolinium enhancement in 2 cases. Abnormalities were more frequent on brachial (86%) than lumbosacral MRIs (29%) and asymmetrical (72%) and most often associated with histological signs of demyelination. The nerve biopsy was suggestive of CIDP in 9/13 patients with normal MRI. Plexus MRI seems useful in the diagnostic strategy of patients with suspicion of CIDP with atypical presentation. Nerve biopsy remains important when other investigations are inconclusive.

Keywords
Adult, Aged, Aged, 80 and over, Brachial Plexus/pathology, Female, Humans, Lumbosacral Plexus/pathology, Magnetic Resonance Imaging, Male, Middle Aged, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating/pathology, Retrospective Studies, Atypical, CIDP, Diagnosis, MRI, Plexus
Pubmed
Web of science
Create date
12/12/2017 18:21
Last modification date
20/08/2019 15:53
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