Whole-body MR neurography: Prospective feasibility study in polyneuropathy and Charcot-Marie-Tooth disease

• Published in: Journal of magnetic resonance imaging Vol. 44; no. 6; pp. 1513 - 1521
• Main Authors: Chhabra, Avneesh, Carrino, John A., Farahani, Sahar J., Thawait, Gaurav K., Sumner, Charlotte J., Wadhwa, Vibhor, Chaudhary, Vinay, Lloyd, Thomas E.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-12-2016; Wiley Subscription Services, Inc
• Subjects: Adult; brachial plexus; Charcot-Marie-Tooth (CMT) disease; Charcot-Marie-Tooth Disease - complications; Charcot-Marie-Tooth Disease - diagnostic imaging; Charcot-Marie-Tooth Disease - pathology; Diffusion Tensor Imaging - methods; Feasibility Studies; Female; Humans; LS plexus; Magnetic resonance imaging; Male; MR neurography; Neuroimaging - methods; Polyneuropathies - complications; Polyneuropathies - diagnostic imaging; Polyneuropathies - pathology; Prospective Studies; Reproducibility of Results; Sensitivity and Specificity; Whole Body Imaging - methods; whole body magnetic resonance imaging; brachial plexus; MR neurography; LS plexus; Charcot-Marie-Tooth (CMT) disease; whole body magnetic resonance imaging
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.25293

Purpose
To evaluate the feasibility of whole‐body magnetic resonance neurography (WBMRN) in polyneuropathy for technical feasibility, distribution of nerve abnormalities, and differentiation.
Materials and Methods
Twenty WBMRN examinations were performed on a 3T scanner over 2 years. Patient demographics including history of hereditary and acquired neuropathy were recorded. The images were evaluated by two independent readers with nerve imaging experience for quality. The nerve signal and size alterations were measured in the brachial plexus, lumbosacral plexus, and femoral and sciatic nerves; diffusion tensor imaging parameters (fractional anisotropy [FA] and apparent diffusion coefficient [ADC]) were determined in plexuses, and tractography was performed. Nonparametric Wilcoxon rank sum test, receiver operating characteristic (ROC) analysis, and intraclass correlation coefficients (ICCs) were obtained.
Results
Excellent image quality was obtained for the majority of lumbosacral (LS) plexus (18/20) and 50% of brachial plexus (10/20) regions. Qualitatively among cases, the nerve hyperintensity and/or thickening involved the brachial plexus (11/11), LS plexus (7/11), and both plexuses (7/11), with most nerve thickenings observed in Charcot‐Marie‐Tooth disease type 1. The nerve signal intensity alterations were significantly different for both brachial (P < 0.05) and LS (P < 0.05) plexuses in cases versus controls. The femoral and sciatic nerve size alterations were different (P < 0.05), while signal intensity differences were not significant (P = 0.1–0.97). Transverse dimensions of C8 (4 mm), L5 (6.2 mm) and S1 (5.1 mm) nerve roots, and sciatic nerves (10.2 mm) were the most accurate diagnostic performance measures in distinguishing cases from controls.
Conclusion
WBMRN is feasible for use in the clinical practice for the identification and potential characterization of polyneuropathy. J. Magn. Reson. Imaging 2016;44:1513–1521.