Heterogeneity of root and nerve ultrasound pattern in CIDP patients

Objective: The few published ultrasound (US) studies on chronic inflammatory demyelinating polyradiculoneuropathy\r\n(CIDP) report diffusely increased cross-sectional area (CSA) of nerves. The data are, however,\r\nheterogeneous and correlations with clinical history or disease severity are lacking.\r\nMethods: Thirty-four patients with CIDP underwent US nerve evaluation by two neurologists blinded to\r\nclinical data. US nerve pattern for each patient was defined by a third neurologist blinded to clinical data.\r\nThree US classes were identified based on CSA and echogenicity: large nerves with hypoechoic nerves/\r\nfascicles (class 1); large nerves with heterogeneous hypo- and hyperechoic fascicles (class 2); normal size\r\nnerve but abnormal hyperechoic array (class 3).\r\nResults: In all patients, US nerve changes were observed: in most of the cases, enlarged nerves or nerve\r\nsegments were observed. The three ‘classes’ of US nerve changes significantly correlated (R: 0.68,\r\np < 0.001) with disease duration, but not with age or Inflammatory Neuropathy Cause and Treatment\r\n(INCAT) disability score.\r\nConclusions: US may be of adjunctive diagnostic value in CIDP assessment. Nerve morphological changes\r\nmay mirror the underlying pathophysiological mechanisms and seem to correlate with disease duration.\r\nSignificance: These results offer the possibility of exploring the use of US to assess CIDP disease activity\r\nand treatment.