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MRI detects peripheral nerve and adjacent muscle pathology in non-systemic vasculitic neuropathy (NSVN)

  • Christian Schneider
  • Alina Sprenger
  • Kilian Weiss
  • Karin Slebocki
  • David Maintz
  • Gereon R. Fink
  • Tobias D. Henning
  • Helmar C. LehmannEmail author
  • Thorsten Lichtenstein
Original Communication

Abstract

Background

Diagnosis and disease monitoring of non-systemic vasculitic neuropathy (NSVN) are based on electrophysiological and clinical measures. However, these methods are insensitive to detect subtle differences of axonal injury. We here assessed the utility of a multiparametric MRI protocol to quantify axonal injury and neurogenic muscle damage in NSVN.

Methods

Ten NSVN patients and ten age-matched controls were investigated in this single-center prospective study. All participants were assessed by diffusion tensor imaging (DTI) of the tibial nerve and multiecho Dixon MRI of soleus and gastrocnemius muscles. These data were correlated with clinical and electrophysiological data.

Results

DTI scans of the tibial nerves of patients with NSVN showed significantly lower mean fractional anisotropy (FA) values (0.32 ± 0.02) compared to healthy controls (0.42 ± 0.01). FA values of NSVN patients correlated negatively with clinical measures of pain. Multiecho Dixon MRI scans revealed significantly higher intramuscular fat fractions in the soleus muscle (19.86 ± 6.18% vs. 5.86 ± 0.74%, p = 0.0015) and gastrocnemius muscle (26.09 ± 6.21% vs. 3.59 ± 0.82%, p = 0.0002) in NSVN patients compared to healthy controls.

Conclusion

Our data provide a proof of concept that MRI can render information about nerve integrity and muscle pathology in NSVN. Further studies are warranted to evaluate DTI and multiecho Dixon MRI as surrogate markers in NSVN.

Keywords

Non-systemic vasculitic neuropathy DTI Proton-density fat fraction Polyneuropathy Neuromuscular disease 

Notes

Acknowledgements

We thank Jan Borggrefe for support in statistical analysis of interrater agreement and Claudia Müller for technical assistance.

Author contributions

CS: study concept, conducting the study, data interpretation, drafting the manuscript. AS: study concept, conducting the study, analysis of data, drafting the manuscript. KW: study concept, technical assistance. KS: analysis of data. DM: study concept, drafting the manuscript for content. GRF: study concept, drafting the manuscript for content. TH: study concept. HCL: study concept, drafting the manuscript for content. TL: study concept, data analysis, drafting the manuscript.

Compliance with ethical standards

Conflicts of interest

KW is an employee of Philips Healthcare Germany since 10/2014. He reports personal fees from Philips Healthcare Germany, during the conduct of the study and personal fees from Philips Healthcare Germany, outside the submitted work. The other authors state that there is no conflict of interest.

Ethical standards

All procedures involving human participants were in accordance with the ethical standards of the institutional research committee and the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all the individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Christian Schneider
    • 1
  • Alina Sprenger
    • 1
  • Kilian Weiss
    • 3
  • Karin Slebocki
    • 2
  • David Maintz
    • 2
  • Gereon R. Fink
    • 1
    • 4
  • Tobias D. Henning
    • 2
    • 5
  • Helmar C. Lehmann
    • 1
    Email author
  • Thorsten Lichtenstein
    • 2
  1. 1.Department of NeurologyUniversity Hospital of Cologne, University of CologneCologneGermany
  2. 2.Department of RadiologyUniversity of CologneCologneGermany
  3. 3.Philips HealthcareHamburgGermany
  4. 4.Institute of Neuroscience and Medicine (INM-3), Research Centre JuelichJuelichGermany
  5. 5.Department of NeuroradiologyKrankenhaus der Barmherzigen Brüder TrierTrierGermany

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