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Diagnostic usefulness of plexus magnetic resonance imaging in chronic inflammatory demyelinating polyradiculopathy without electrodiagnostic criteria of demyelination.

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Title: Diagnostic usefulness of plexus magnetic resonance imaging in chronic inflammatory demyelinating polyradiculopathy without electrodiagnostic criteria of demyelination.
Authors: Fargeot, G., Viala, K., Theaudin, M., Labeyrie, M.‐A., Costa, R., Léger, J. M., Adams, D., Vandendries, C., Labeyrie, C.
Source: European Journal of Neurology. Apr2019, Vol. 26 Issue 4, p631-638. 8p. 2 Color Photographs, 1 Diagram, 3 Charts.
Subjects: Magnetic resonance imaging
Abstract: Background and purpose: The usefulness of plexus magnetic resonance imaging (MRI) in the diagnosis of chronic inflammatory demyelinating polyradiculopathy (CIDP) without definite European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria is currently unclear. Methods: Data from consecutive patients with clinical manifestations suggesting CIDP, with or without (CIDP‐D and CIDP‐ND, respectively) definite EFNS/PNS electrodiagnostic criteria, and referred for plexus MRI in our imaging centre were retrospectively analysed. An expert committee of neurologists compared the level of suspicion of CIDP in CIDP‐ND patients to the blinded/unblinded MRI findings. Plexus MRI was reviewed by a neuroradiologist blinded to the final diagnosis. Results: In all, 38 patients were assessed with suspected CIDP‐ND [7/38 (18%) probable; 13/38 (34%) possible; 18/38 (47%), no EFNS/PNS electrodiagnostic criteria], plus 10 with CIDP‐D. Thirty‐six of the 38 (95%) fulfilled clinical criteria of CIDP variants, including pure sensory neuropathy in 22/36 (61%). Plexus MRI showed abnormalities in 22/38 (58%) patients including increased nerve signal intensity on T2‐weighted images in 22/22 (100%), nerve enlargement in 20/22 (91%) and contrast enhancement in 8/22 (36%). Plexus MRI enabled the expert committee's final diagnosis to be adjusted in 7/38 (18%) patients, and in conjunction with nerve conduction studies was a supportive criterion to classify 7/24 (29%) patients as definite CIDP. MRI abnormalities were more asymmetrical (P = 0.03) and less diffuse (P = 0.1) in CIDP‐ND than in CIDP‐D. Conclusions: Our observations suggest that plexus MRI makes a valuable contribution to the diagnosis of CIDP‐ND patients. Further studies are needed to investigate inter‐rater reliability of clinical and imaging criteria of CIDP in these patients, and the impact on outcomes. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Diagnostic usefulness of plexus magnetic resonance imaging in chronic inflammatory demyelinating polyradiculopathy without electrodiagnostic criteria of demyelination.
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  Data: <searchLink fieldCode="AR" term="%22Fargeot%2C+G%2E%22">Fargeot, G.</searchLink><br /><searchLink fieldCode="AR" term="%22Viala%2C+K%2E%22">Viala, K.</searchLink><br /><searchLink fieldCode="AR" term="%22Theaudin%2C+M%2E%22">Theaudin, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Labeyrie%2C+M%2E‐A%2E%22">Labeyrie, M.‐A.</searchLink><br /><searchLink fieldCode="AR" term="%22Costa%2C+R%2E%22">Costa, R.</searchLink><br /><searchLink fieldCode="AR" term="%22Léger%2C+J%2E+M%2E%22">Léger, J. M.</searchLink><br /><searchLink fieldCode="AR" term="%22Adams%2C+D%2E%22">Adams, D.</searchLink><br /><searchLink fieldCode="AR" term="%22Vandendries%2C+C%2E%22">Vandendries, C.</searchLink><br /><searchLink fieldCode="AR" term="%22Labeyrie%2C+C%2E%22">Labeyrie, C.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Apr2019, Vol. 26 Issue 4, p631-638. 8p. 2 Color Photographs, 1 Diagram, 3 Charts.
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  Data: Background and purpose: The usefulness of plexus magnetic resonance imaging (MRI) in the diagnosis of chronic inflammatory demyelinating polyradiculopathy (CIDP) without definite European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria is currently unclear. Methods: Data from consecutive patients with clinical manifestations suggesting CIDP, with or without (CIDP‐D and CIDP‐ND, respectively) definite EFNS/PNS electrodiagnostic criteria, and referred for plexus MRI in our imaging centre were retrospectively analysed. An expert committee of neurologists compared the level of suspicion of CIDP in CIDP‐ND patients to the blinded/unblinded MRI findings. Plexus MRI was reviewed by a neuroradiologist blinded to the final diagnosis. Results: In all, 38 patients were assessed with suspected CIDP‐ND [7/38 (18%) probable; 13/38 (34%) possible; 18/38 (47%), no EFNS/PNS electrodiagnostic criteria], plus 10 with CIDP‐D. Thirty‐six of the 38 (95%) fulfilled clinical criteria of CIDP variants, including pure sensory neuropathy in 22/36 (61%). Plexus MRI showed abnormalities in 22/38 (58%) patients including increased nerve signal intensity on T2‐weighted images in 22/22 (100%), nerve enlargement in 20/22 (91%) and contrast enhancement in 8/22 (36%). Plexus MRI enabled the expert committee's final diagnosis to be adjusted in 7/38 (18%) patients, and in conjunction with nerve conduction studies was a supportive criterion to classify 7/24 (29%) patients as definite CIDP. MRI abnormalities were more asymmetrical (P = 0.03) and less diffuse (P = 0.1) in CIDP‐ND than in CIDP‐D. Conclusions: Our observations suggest that plexus MRI makes a valuable contribution to the diagnosis of CIDP‐ND patients. Further studies are needed to investigate inter‐rater reliability of clinical and imaging criteria of CIDP in these patients, and the impact on outcomes. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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