, Volume 55, Issue 1, pp 41–48 | Cite as

Sensory neuronopathy involves the spinal cord and brachial plexus: a quantitative study employing multiple-echo data image combination (MEDIC) and turbo inversion recovery magnitude (TIRM)

Diagnostic Neuroradiology



Sensory neuronopathy (SNN) is a distinctive subtype of peripheral neuropathies, specifically targeting dorsal root ganglion (DRG). We utilized MRI to demonstrate the imaging characteristics of DRG, spinal cord (SC), and brachial plexus at C7 level in SNN.


We attempted multiple-echo data image combination (MEDIC) and turbo inversion recovery magnitude (TIRM) methods in nine patients with sensory neuronopathy and compared with those in 16 disease controls and 20 healthy volunteers. All participants underwent MRI for the measurement of DRG, posterior column (PC), lateral column, and spinal cord area (SCA) at C7 level. DRG diameters were obtained through its largest cross section, standardized by dividing sagittal diameter of mid-C7 vertebral canal. We also made comparisons of standardized anteroposterior diameter (APD) and left–right diameters of SC and PC in these groups. Signal intensity and diameter of C7 spinal nerve were assessed on TIRM.


Compared to control groups, signal intensities of DRG and PC were higher in SNN patients when using MEDIC, but the standardized diameters were shorter in either DRG or PC. Abnormal PC signal intensities were identified in eight out of nine SNN patients (89 %) with MEDIC and five out of nine (56 %) with T2-weighted images. SCA, assessed with MEDIC, was smaller in SNN patients than in the other groups, with significant reduction of its standardized APD. C7 nerve root diameters, assessed with TIRM, were decreased in SNN patients.


MEDIC and TIRM sequences demonstrate increased signal intensities and decreased area of DRG and PC, and decreased diameter of nerve roots in patients with SNN, which can play a significant role in early diagnosis.


Sensory neuronopathy Dorsal root ganglion Posterior column Multiple-echo data image combination Turbo inversion recovery magnitude 



The authors thank Hui Zhang PhD., from the Department of Computer Science and Centre for Medical Image Computing, University College London, UK, for critical comments and helpful suggestions. We also would like to thank Huan Xu for her kind help in revising the manuscript.

Conflict of interest

We declare that we have no conflict of interest.


  1. 1.
    Martinez AR, Nunes MB et al (2012) Sensory neuronopathy and autoimmune diseases. Autoimmune Dis 2012:873587PubMedGoogle Scholar
  2. 2.
    Damasceno A, Franca MC Jr et al (2008) Chronic acquired sensory neuron diseases. Eur J Neurol 15(12):1400–1405PubMedCrossRefGoogle Scholar
  3. 3.
    Lauria G, Pareyson D et al (2003) Neurophysiological diagnosis of acquired sensory ganglionopathies. Eur Neurol 50(3):146–152PubMedCrossRefGoogle Scholar
  4. 4.
    Denny-Brown D (1948) Primary sensory neuropathy with muscular changes associated with carcinoma. J Neurol Neurosurg Psychiatry 11(2):73–87PubMedCrossRefGoogle Scholar
  5. 5.
    Kuntzer T, Antoine J-C et al (2004) Clinical features and pathophysiological basis of sensory neuronopathies (ganglionopathies). Muscle Nerve 30(3):255–268PubMedCrossRefGoogle Scholar
  6. 6.
    Sghirlanzoni A, Pareyson D et al (2005) Sensory neuron diseases. Lancet Neurol 4(6):349–361PubMedCrossRefGoogle Scholar
  7. 7.
    Krarup-Hansen A, Helweg-Larsen S et al (2007) Neuronal involvement in cisplatin neuropathy: prospective clinical and neurophysiological studies. Brain 130(Pt 4):1076–1088PubMedGoogle Scholar
  8. 8.
    Sheikh SI, Amato AA (2010) The dorsal root ganglion under attack: the acquired sensory ganglionopathies. Pract Neurol 10(6):326–334PubMedCrossRefGoogle Scholar
  9. 9.
    Pavlakis PP, Alexopoulos H et al (2012) Peripheral neuropathies in Sjogren's syndrome: a critical update on clinical features and pathogenetic mechanisms. J Autoimmun 39(1–2):27–33PubMedCrossRefGoogle Scholar
  10. 10.
    Mori K, Iijima M et al (2005) The wide spectrum of clinical manifestations in Sjogren's syndrome-associated neuropathy. Brain 128:2518–2534PubMedCrossRefGoogle Scholar
  11. 11.
    Franca MC Jr, D'Abreu A et al (2008) MRI shows dorsal lesions and spinal cord atrophy in chronic sensory neuronopathies. J Neuroimaging 18(2):168–172PubMedCrossRefGoogle Scholar
  12. 12.
    Walk D (2009) Role of skin biopsy in the diagnosis of peripheral neuropathic pain. Curr Pain Headache Rep 13(3):191–196PubMedCrossRefGoogle Scholar
  13. 13.
    Lauria G, Sghirlanzoni A et al (2001) Epidermal nerve fiber density in sensory ganglionopathies: clinical and neurophysiologic correlations. Muscle Nerve 24(8):1034–1039PubMedCrossRefGoogle Scholar
  14. 14.
    Lauria G, Lombardi R (2012) Small fiber neuropathy: is skin biopsy the holy grail? Curr Diab Rep 12(4):384–392PubMedCrossRefGoogle Scholar
  15. 15.
    Colli BO, Carlotti CG et al (2008) Dorsal root ganglionectomy for the diagnosis of sensory neuropathies. Surgical technique and results. Surg Neurol 69(3):266–273PubMedCrossRefGoogle Scholar
  16. 16.
    Asbury AK (1987) Sensory neuronopathy. Semin Neurol 7(1):58–66PubMedCrossRefGoogle Scholar
  17. 17.
    Asbury AK, Brown MJ (1990) Sensory neuronopathy and pure sensory neuropathy. Curr Opin Neurol Neurosurg 3:708–711Google Scholar
  18. 18.
    Camdessanche JP, Jousserand G et al (2009) The pattern and diagnostic criteria of sensory neuronopathy: a case-control study. Brain 132(Pt 7):1723–1733PubMedCrossRefGoogle Scholar
  19. 19.
    Lauria G, Pareyson D et al (2000) Clinical and magnetic resonance imaging findings in chronic sensory ganglionopathies. Ann Neurol 47(1):104–109PubMedCrossRefGoogle Scholar
  20. 20.
    Sobue G, Yasuda T et al (1995) MRI demonstrates dorsal column involvement of the spinal cord in Sjogren's syndrome-associated neuropathy. Neurology 45(3 Pt 1):592–593PubMedCrossRefGoogle Scholar
  21. 21.
    Grant GA, Goodkin R et al (2004) MR neurography: diagnostic utility in the surgical treatment of peripheral nerve disorders. Neuroimaging Clin N Am 14(1):115–133PubMedCrossRefGoogle Scholar
  22. 22.
    Schmid MR, Pfirrmann CW et al (2005) Imaging of patellar cartilage with a 2D multiple-echo data image combination sequence. AJR Am J Roentgenol 184(6):1744–1748PubMedGoogle Scholar
  23. 23.
    Vertinsky AT, Krasnokutsky MV et al (2007) Cutting-edge imaging of the spine. Neuroimaging Clin N Am 17(1):117–136PubMedCrossRefGoogle Scholar
  24. 24.
    Viallon M, Vargas MI et al (2008) High-resolution and functional magnetic resonance imaging of the brachial plexus using an isotropic 3D T2 STIR (Short Term Inversion Recovery) SPACE sequence and diffusion tensor imaging. Eur Radiol 18(5):1018–1023PubMedCrossRefGoogle Scholar
  25. 25.
    Mori K, Koike H et al (2001) Spinal cord magnetic resonance imaging demonstrates sensory neuronal involvement and clinical severity in neuronopathy associated with Sjogren's syndrome. J Neurol Neurosurg Psychiatry 71(4):488–492PubMedCrossRefGoogle Scholar
  26. 26.
    Ko HY, Park JH et al (2004) Gross quantitative measurements of spinal cord segments in human. Spinal Cord 42(1):35–40PubMedCrossRefGoogle Scholar
  27. 27.
    West CA, McKay Hart A et al (2011) Sensory neurons of the human brachial plexus: a quantitative study employing optical fractionation and in-vivo volumetric magnetic resonance imaging. Neurosurgery 70(5):1183–1194, discussion 1194CrossRefGoogle Scholar
  28. 28.
    Okumura R, Asato R et al (1992) Degeneration of the posterior columns of the spinal cord: postmortem MRI and histopathology. J Comput Assist Tomogr 16(6):865–867PubMedCrossRefGoogle Scholar
  29. 29.
    Lin CC, Chiu MJ (2008) Teaching neuroimage: cervical cord atrophy with dorsal root ganglionopathy in Sjogren syndrome. Neurology 70(7):e27PubMedCrossRefGoogle Scholar
  30. 30.
    Koike H, Atsuta N et al (2010) Clinicopathological features of acute autonomic and sensory neuropathy. Brain 133:2881–2896PubMedCrossRefGoogle Scholar
  31. 31.
    Tavee J, Zhou L (2009) Small fiber neuropathy: a burning problem. Cleve Clin J Med 76(5):297–305PubMedCrossRefGoogle Scholar
  32. 32.
    Koike H, Sobue G (2008) Small neurons may be preferentially affected in ganglionopathy. J Neurol Neurosurg Psychiatry 79(2):113PubMedCrossRefGoogle Scholar
  33. 33.
    Kastrup O, Timman D et al (2010) Isolated degeneration of the posterior column as a distinct entity—a clinical and electrophysiologic follow-up study. Clin Neurol Neurosurg 112(3):209–212PubMedCrossRefGoogle Scholar
  34. 34.
    Ishikawa M, Matsumoto M et al (2003) Changes of cervical spinal cord and cervical spinal canal with age in asymptomatic subjects. Spinal Cord 41(3):159–163PubMedCrossRefGoogle Scholar
  35. 35.
    Zivadinov R, Banas AC et al (2008) Comparison of three different methods for measurement of cervical cord atrophy in multiple sclerosis. AJNR Am J Neuroradiol 29(2):319–325PubMedCrossRefGoogle Scholar
  36. 36.
    Lundell H, Barthelemy D et al (2011) Independent spinal cord atrophy measures correlate to motor and sensory deficits in individuals with spinal cord injury. Spinal Cord 49(1):70–75PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Yi-Fang Bao
    • 1
  • Wei-Jun Tang
    • 1
  • Dong-Qing Zhu
    • 2
  • Yu-Xin Li
    • 1
  • Chi-Shing Zee
    • 3
  • Xiang-Jun Chen
    • 2
  • Dao-Ying Geng
    • 1
  1. 1.Department of Radiology, Huashan HospitalFudan UniversityShanghaiChina
  2. 2.Department of Neurology, Huashan HospitalFudan UniversityShanghaiChina
  3. 3.Department of RadiologyUniversity of Southern California Keck School of MedicineLos AngelesUSA

Personalised recommendations