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Eur J Neurol. 2017 Oct;24(10):1307-1313. doi: 10.1111/ene.13380. Epub 2017 Aug 1.

A comparative study of brachial plexus sonography and magnetic resonance imaging in chronic inflammatory demyelinating neuropathy and multifocal motor neuropathy.

Author information

1
Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
2
Department of Neurology and Clinical Neurophysiology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
3
Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
4
Department of Biostatistics, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands.

Abstract

BACKGROUND AND PURPOSE:

To compare the performance of neuroimaging techniques, i.e. high-resolution ultrasound (HRUS) and magnetic resonance imaging (MRI), when applied to the brachial plexus, as part of the diagnostic work-up of chronic inflammatory demyelinating neuropathy (CIDP) and multifocal motor neuropathy (MMN).

METHODS:

Fifty-one incident, treatment-naive patients with CIDP (n = 23) or MMN (n = 28) underwent imaging of the brachial plexus using (i) a standardized MRI protocol to assess enlargement or T2 hyperintensity and (ii) bilateral HRUS to determine the extent of nerve (root) enlargement.

RESULTS:

We found enlargement of the brachial plexus in 19/51 (37%) and T2 hyperintensity in 29/51 (57%) patients with MRI and enlargement in 37/51 (73%) patients with HRUS. Abnormal results were only found in 6/51 (12%) patients with MRI and 12/51 (24%) patients with HRUS. A combination of the two imaging techniques identified 42/51 (83%) patients. We found no association between age, disease duration or Medical Research Council sum-score and sonographic nerve size, MRI enlargement or presence of T2 hyperintensity.

CONCLUSIONS:

Brachial plexus sonography could complement MRI in the diagnostic work-up of patients with suspected CIDP and MMN. Our results indicate that combined imaging studies may add value to the current diagnostic consensus criteria for chronic inflammatory neuropathies.

KEYWORDS:

brachial plexus; chronic inflammatory demyelinating polyneuropathy; magnetic resonance imaging; multifocal motor neuropathy; ultrasound

PMID:
28762574
DOI:
10.1111/ene.13380
[Indexed for MEDLINE]

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