Akio Hiwatashi1, Osamu Togao1, Koji Yamashita1, Kazufumi Kikuchi1, Masami Yoneyama2, and Hiroshi Honda1
1Clinical Radiology, Kyushu University, Fukuoka, Japan, 2Philips Electronics Japan, Tokyo, Japan
Synopsis
MR neurography (MRN) is a
useful technique with which to evaluate abnormal conditions of the peripheral
nerves such as chronic inflammatory demyelinating
polyradiculoneuropathy (CIDP). We have developed a new simultaneous T2 mapping and
MRN method called SHINKEI Quant. Patients with CIDP could be distinguished from
normal subjects in size and T2 value of the peripheral nerves with SHINKEI
Quant.Purpose
MR neurography (MRN) is a
useful technique with which to evaluate abnormal conditions of the peripheral
nerves such as chronic inflammatory demyelinating
polyradiculoneuropathy (CIDP). Various MRN techniques were advocated, however,
it is difficult to analyze T2 mapping of the peripheral nerves with high
spatial resolution. We have developed the new T2 mapping method called SHINKEI
Quant using three-dimensional nerve-sheath signal increased with inked
rest-tissue rapid acquisition of relaxation imaging (1). The purpose of this
study is to discriminate the patients with CIDP from normal subjects using SHINKEI
Quant.
Methods
Three patients with CIDP (2 males and 1 female; age
range 51 - 65 year old; median 52 year) and 5 normal subjects (5 males; age
range 25 - 43 year old; median 30 year) were studied. MRI was conducted on a 3T
clinical scanner (Ingenia CX, Philips Healthcare, NL). Typical imaging
parameters were as follows; TR/TE = 2400/61 ms, FOV = 220 x 310 mm for cervical
and 280 x 394 mm for lumbar spine, ETL = 100, matrix = 224 x 320 for cervical
and 256 x 360 for lumbar spine, voxel size = 0.98 x 0.98 x 2.0 mm
3
for cervical and 1.09 x 1.09 x 1.8 mm
3 for lumbar spine, b = 10 s/mm
2,
iMSDE duration = 36 and 72 ms, acquisition time = 6 min 18 s for cervical and 6
min 14 s for lumbar spine. T2 values and size of the nerves at C5-T1 and T12-L5
were evaluated. Statistical analysis was performed with Mann-Whitney U test. A
p-value less than 0.05 was considered significant.
Results
The size of the patients with
CIDP (4.61 ± 0.94 mm for cervical and 4.66 ± 1.37 mm for lumbar spine) was
significantly larger than in the normal subjects (3.50 ± 0.62 mm for cervical
and 3.66 ± 0.75 mm for lumbar spine; P<0.01). T2 of the patients with CIDP
(106.84 ± 17.28 for cervical and 116.47 ± 18.71 for lumbar spine) was
significantly larger than in the normal subjects (85.29 ± 13.22 for cervical
and 74.96 ± 10.98 for lumbar spine; P<0.001).
Discussion
Previous qualitative studies
have shown increased signal intensity on T2-weighted images in the brachial
plexus or nerve trunks in patients with CIDP (3). With our new MRN with T2
mapping technique, we could discriminate the patients with CIDP from normal
subjects qualitatively.
Conclusion
Patients with CIDP could be distinguished from normal patients in size
and T2 value of the peripheral nerves with SHINKEI Quant.
Acknowledgements
NoneReferences
1. Yoneyama M, Takahara T, Kwee TC, et al. Rapid high
resolution MR neurography with a diffusion-weighted pre-pulse. Magn Reson Med
Sci. 2013;12(2):111-119.
2. Kasper JM, Wadhwa V, Scott KM, et al.
SHINKEI-a novel 3D isotropic MR neurography technique: technical advantages
over 3DIRTSE-based imaging. Eur Radiol. 2015;25(6):1672-1677.
3. Tazawa K, Matsuda M, Yoshida T, et al.
Spinal nerve root hypertrophy on MRI: clinical significance in the diagnosis of
chronic inflammatory demyelinating polyradiculoneuropathy. Intern Med.
2008;47(23):2019-2024.