Magnetic Resonance Neurography Of Lumbar Plexus In Patients With Guillain-Barre Syndrome

Objective:1.To Compare the difference between the data of normal lumbar plexus nerve measured through Magnetic Resonance Neurography (MRN)with specimen.2.To investigate the value of diagnosis in patients with Guillain-Barre syndrome(GBS) using Magnetic Resonance Neurography(MRN).Methods:1.Volunteers or 30 healthy lumbar plexus nerve cases (19 males and 11 females)were selected, to measure the short shaft line and neuromuscular signal ratio of the right normal lumbar nerve root, ganglia, nerve and the femoral nerve stem, anatomy and measurements of the right lumbar plexus L2-5 nerve root, ganglia and nerve stem, femoral nerve morphology and size. And comparison of MRN measurement data and autopsy measurement data were conducted.2. MRN was performed to evaluate the lumbar plexus, in 28 patients with clinically diagnosed Guillain-Barre syndrome (GBS) and 30 healthy volunteers. The right L4 nerve root, ganglion, nerve trunk and femoral nerve morphology and signal intensity were evaluated in the healthy volunteers. The peripheral nerve and adjacent tissue changes were observed in patients with GBS. The morphology, size and signal of the right nerve root, ganglion and femoral nerve as well as the brachyaxis and nerve-muscle signal ratio were also measured. In addition, we measured the CSF protein content and cytology and compared the MRN measurements and data in the GBS group. The protein content in the GBS group and its relationship to the NMSR were also evaluated.Results:1.MRN could clearly show L2-5 nerve course, ganglion being circle or Oval enlargement, with the size about 3 mm-6mm; a nerve root and stem displayed strips and smooth edge, with the size about 2 mm-5 mm, nerve Festival signal is more than the nerve root and stem. There was no significant statistical difference with the comparability between the obtained data and autopsy ones.2.80.9% of the lumbar plexus in the GBS group had vague hyperintensities, whereas, the nerve root and ganglion size were normal. We also noticed nerve trunk thickening in 25% patients and 50% patients had increased nerve cord signal intensity and vague periphery in nerve trunks. Compared with normal L4 lumbar plexus, no significant changes of nerve root,nerve trunk and ganglion were observed in GBS group (t=1.74,1.24, 1.68, P>0.05) No significant changes of nerve root and ganglion NMSR were observed. (t=1.93,1.86, P>0.05). However, we also noticed the thickening of femoral nerve(t=3.44,P<0.05) and increased NMSR(t=5.64,19.04, P< 0.05) in the nerve truck and femoral nerve. The protein content, nerve trunk and nerve NMSR were positively correlated. (rs =0.767,0.667,P<0.001)。Conclusions:1.MRN can clearly show lumbar plexus and major branches; its measured value can reflect changes in lumbar plexus. It is possible for diagnostic criteria of the lumbar plexus nerve diseases and dysplasia.2. Exudation around the nerve and increased nerve trunk and nerve root NMSR were observed in GBS, while nerve thickening was not obvious in patients with GBS. The changes in the GBS protein content may lead to nerve trunk and femoral nerve NMSR changes. MRN may be useful in the diagnosis of GBS.