Contrast‐enhanced Magnetic Resonance Imaging of the Lumbosacral Roots in the Dysimmune Inflammatory Polyneuropathies

Abstract

The diagnosis of acute Guillain-Barré syndrome and chronic inflammatory demyelinating polyradiculoneuropathy is based on clinical characteristics, abnormalities on nerve conduction studies, and nerve biopsy specimens indicating demyelination. Inflammation and edema are also common findings in nerve specimens. Immunotherapy is helpful in these dysimmune conditions. Occasionally the diagnosis is difficult to make, particularly when electrophysiological testing or nerve biopsy findings are not characteristic. The authors found contrast enhancement of lumbosacral roots in patients with chronic inflammatory demyelinating polyradiculoneuropathy and Guillain-Barré syndrome, but not in those with other demyelinating neuropathies. Contrast-enhanced magnetic resonance imaging could be a useful tool in the diagnosis of the dysimmune inflammatory neuropathies.

Detection of cervical nerve root hypertrophy by ultrasonography in chronic inflammatory demyelinating polyradiculoneuropathy

“…Several studies have revealed abnormal enhancement of spinal nerve roots [2,3,5,9 -13], which has also been demonstrated in Guillain -Barré syndrome [29,30]. Hypertrophy of nerve roots has often been described in combination with abnormal enhancement [2,3,5,11 -13], showing spinal stenosis in some cases [4,5,12,13].…”

Neuroimaging in diagnosis of atypical polyradiculoneuropathies: report of three cases and review of the literature

“…The first reports on MRI findings in patients affected by CIDP described nerve root enlargement mostly within the cauda equina and spinal roots [13,14], with different degrees of gadolinium enhancement, which is not considered sufficient for a differential diagnosis with GuillanBarrè syndrome (GBS) [15,16].…”

Vasculitic polyradiculopathy in systemic lupus erythematosus

“…Such enhancement is a non-specific finding which has previously been documented in Guillain-Barré syndrome, CIDP, meningeal carcinomatosis, infectious polyradiculitis, arachnoiditis, and sarcoidsois 10. Nerve root enhancement has not previously been reported either in systemic lupus erythematosus associated, or in vasculitic, polyradiculopathy.…”