Diffusion tensor imaging of peripheral nerve in patients with chronic inflammatory demyelinating polyradiculoneuropathy: a feasibility study

Kakuda, Takako; Fukuda, Hiroshi; Tanitame, Keizo; Takasu, Miyuki; Date, Shuji; Ochi, Kazuhide; Ohshita, Tomohiko; Kohriyama, Tatsuo; Ito, Katsuhide; Matsumoto, Masayasu; Awai, Kazuo

doi:10.1007/s00234-010-0833-z

Cited by 68 publications

(80 citation statements)

References 22 publications

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“…Previous studies have consistently demonstrated that DTI derived FA in rodent22, 43, 44 and human peripheral nerves is a valid measure for axonal injury 17, 21, 23…”

Section: Discussionmentioning

confidence: 87%

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MRI biomarkers of proximal nerve injury in CIDP

Lichtenstein

Sprenger

Weiss

et al. 2017

Ann Clin Transl Neurol

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ObjectiveTo evaluate the utility of nerve diffusion tensor imaging (DTI), nerve cross‐sectional area, and muscle magnetic resonance imaging (MRI) multiecho Dixon for assessing proximal nerve injury in chronic inflammatory demyelinating polyneuropathy (CIDP).MethodsIn this prospective observational cohort study, 11 patients with CIDP and 11 healthy controls underwent a multiparametric MRI protocol with DTI of the sciatic nerve and assessment of muscle proton‐density fat fraction of the biceps femoris and the quadriceps femoris muscles by multiecho Dixon MRI. Patients were longitudinally evaluated by MRI, clinical examination, and nerve conduction studies at baseline and after 6 months.ResultsIn sciatic nerves of CIDP patients, mean cross‐sectional area was significantly higher and fractional anisotropy value was significantly lower, compared to controls. In contrast, muscle proton‐density fat fraction was significantly higher in thigh muscles of patients with CIDP, compared to controls. MRI parameters showed high reproducibility at baseline and 6 months.InterpretationAdvanced MRI parameters demonstrate subclinical proximal nerve damage and intramuscular fat accumulation in CIDP. Data suggest DTI and multiecho Dixon MRI might be useful in estimating axonal damage and neurogenic muscle changes in CIDP.

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“…Previous studies have consistently demonstrated that DTI derived FA in rodent22, 43, 44 and human peripheral nerves is a valid measure for axonal injury 17, 21, 23…”

Section: Discussionmentioning

confidence: 87%

“…This method is useful to provide anatomical data and to detect pathologies such as tumors that affect the continuity of nerves 18, 19. More recently, diffusion tensor imaging of peripheral nerves has been introduced as a tool to quantify nerve damage and regeneration 20, 21, 22…”

Section: Introductionmentioning

confidence: 99%

MRI biomarkers of proximal nerve injury in CIDP

Lichtenstein

Sprenger

Weiss

et al. 2017

Ann Clin Transl Neurol

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“…DTI has mainly been applied to the functional analysis and diagnosis of diseases in the central nervous system. Recently, this technique has also been applied to several peripheral nerves, namely the median nerve, 12 tibial nerve 13,14 and lumbar plexus. 15 Those studies demonstrated that the ADC and FA could reflect the pathological conditions of peripheral nerves.…”

Section: Introductionmentioning

confidence: 99%

Diffusion tensor imaging of the inferior alveolar nerve using 3T MRI: a study for quantitative evaluation and fibre tracking

Kotaki¹,

Sakamoto²,

Kretapirom³

et al. 2016

Dentomaxillofacial Radiology

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Objectives: Diffusion tensor imaging (DTI) can provide structural information and objective values for nerves. The aims of this study were to perform quantitative evaluation and fibre tracking of the normal inferior alveolar nerve (IAN) using DTI on 3.0-T MRI. Methods: DTI was applied to 92 IANs of 46 healthy volunteers. Circular regions of interest (ROIs) were placed on three different positions at the mandibular foramen, second molar and mental foramen of each nerve on apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps, and the ADC and FA of each ROI were measured. Differences in the values arising from the nerve positions were evaluated. Furthermore, fibre tracking of the IANs was performed by tractography, and the quality of visualization was evaluated. Results: There were no significant differences in the ADC and FA between the right and left sides regardless of the anteroposterior positions. Regarding differences arising from the anteroposterior measurement positions, the ADC and FA showed no significant differences (p . 0.017), except for the ADCs between the positions at the mandibular foramen and mental foramen in the left side (p 5 0.0068). Overall, 70 (76%) of the 92 IANs could be visualized fully or partially by tractography. Conclusions: The ADC and FA of the IAN were successfully obtained from healthy volunteers using DTI and were confirmed to be symmetrical regardless of the measurement positions. DTI is a feasible technique for the quantitative evaluation and visualization of the IAN.

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“…Nerve pathology can also be probed directly via quantitative MRI techniques. For example, diffusion MRI of peripheral nerves yields metrics that relate to disability 18,19 ; however, this method often requires longer, lower resolution acquisitions than desired. Similar to diffusion MRI, magnetization transfer ratio (MTR) imaging is sensitive to changes in myelin density that can occur from demyelination or axonal loss, 20 and fast, high-resolution MTR imaging of peripheral nerves is feasible.…”

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confidence: 99%

Proximal nerve magnetization transfer MRI relates to disability in Charcot-Marie-Tooth diseases

et al. 2014

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Objective: The objectives of this study were (1) to develop a novel magnetization transfer ratio (MTR) MRI assay of the proximal sciatic nerve (SN), which is inaccessible via current tools for assessing peripheral nerves, and (2) to evaluate the resulting MTR values as a potential biomarker of myelin content changes in patients with Charcot-Marie-Tooth (CMT) diseases.Methods: MTR was measured in the SN of patients with CMT type 1A (CMT1A, n 5 10), CMT type 2A (CMT2A, n 5 3), hereditary neuropathy with liability to pressure palsies (n 5 3), and healthy controls (n 5 21). Additional patients without a genetically confirmed subtype (n 5 4), but whose family histories and electrophysiologic tests were consistent with CMT, were also included. The relationship between MTR and clinical neuropathy scores was assessed, and the interscan and inter-rater reliability of MTR was estimated.Results: Mean volumetric MTR values were significantly decreased in the SN of patients with CMT1A (33.8 6 3.3 percent units) and CMT2A (31.5 6 1.9 percent units) relative to controls (37.2 6 2.3 percent units). A significant relationship between MTR and disability scores was also detected (p 5 0.01 for genetically confirmed patients only, p 5 0.04 for all patients). From interscan and inter-rater reliability analyses, proximal nerve MTR values were repeatable at the slicewise and mean volumetric levels. Charcot-Marie-Tooth (CMT) diseases are a group of inherited neuropathies that affect motor and sensory nerves. A majority of CMT phenotypes can be classified as primary demyelination/dysmyelinating (CMT1) or primary axonal (CMT2) neuropathies.1,2 CMT type 1A (CMT1A z 80% of CMT1 cases 3,4 ) arises from duplication of the peripheral myelin protein 22 (PMP22) gene 5,6 and results in dysmyelination and secondary axonal loss. 7 CMT type 2A (CMT2A z 35% of CMT2 cases 8 ) is caused by missense mutations in the gene that encodes for mitofusin 2 9 and leads to primary axonal degeneration. 8 Although the pathologic features of CMT1A/CMT2A are different, length-dependent axonal loss occurs in both and is predictive of outcomes.

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Diffusion tensor imaging of peripheral nerve in patients with chronic inflammatory demyelinating polyradiculoneuropathy: a feasibility study

Abstract: Our preliminary data suggest that the noninvasive DTI assessment of peripheral nerves may provide useful information in patients with CIDP.

Cited by 68 publications

References 22 publications

MRI biomarkers of proximal nerve injury in CIDP

MRI biomarkers of proximal nerve injury in CIDP

Diffusion tensor imaging of the inferior alveolar nerve using 3T MRI: a study for quantitative evaluation and fibre tracking

Proximal nerve magnetization transfer MRI relates to disability in Charcot-Marie-Tooth diseases

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