Nerve Hypertrophy and Altered Diffusion in Anti-Myelin-Associated Glycoprotein Neuropathy Detected by Brachial Plexus Magnetic Resonance Neurography

磁共振神经造影术 臂丛神经 医学 部分各向异性 磁共振成像 正中神经 髓鞘 周围神经病变 肌肉肥大 磁共振弥散成像 解剖 病理 内科学 内分泌学 放射科 中枢神经系统 糖尿病
作者
Kyosuke Koide,Atsuhiko Sugiyama,Hajime Yokota,Hiroyuki Mukai,Jiaqi Wang,Keigo Nakamura,Sonoko Misawa,Shingo Ito,Satoshi Kuwabara
出处
期刊:European Neurology [Karger Publishers]
卷期号:85 (2): 95-103 被引量:6
标识
DOI:10.1159/000519128
摘要

This study assessed the morphological changes and diffusion tensor imaging (DTI)-derived parameters of the brachial plexus using magnetic resonance neurography (MRN) in patients with anti-myelin-associated glycoprotein (anti-MAG) neuropathy.Eight patients with anti-MAG neuropathy underwent MRN of the brachial plexus with 3-dimensional (3D) short tau inversion recovery (STIR) and DTI sequences. Two neuroradiologists and a neurologist qualitatively assessed nerve hypertrophy on 3D STIR MRN. The cross-sectional area (CSA) of the nerve roots was measured. Quantitative analyses of fractional anisotropy (FA) and axial, radial, and mean diffusivity (AD, RD, and MD) were obtained after postprocessing on DTI and manual segmentation.There was nerve hypertrophy in 37.5% of the patients with anti-MAG neuropathy. All patients with anti-MAG neuropathy with nerve hypertrophy were refractory to rituximab therapy. The CSA of the nerve roots was inversely correlated with FA and positively correlated with MD and RD. FA decreased in the nerve roots and inversely correlated with disease duration.Nerve hypertrophy appears in the proximal portion of peripheral nerves, such as the brachial plexus, in patients with anti-MAG neuropathy. Altered diffusion in the nerve roots might be associated with the loss of myelin integrity due to the demyelination process in anti-MAG neuropathy.
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