Enhanced Magnetic Resonance Imaging Of The Spine For The Diagnosis Of Guillain-barre Syndrome In Children

Objective：To evaluate enhanced magnetic resonance imaging of the spine for thediagnosis of Guillain-Barre syndrome (GBS) in children.Methods：Clinical and imaging data of17pediatric patients with GBS which wereadmitted into our hospital on2010.01~2013.03were retrospectivelyanalyzed. Plain and enhanced magnetic resonance imaging of the spine wasperformed in all cases. We analysed that whether lumbosacral nerve rootsand cauda equine have thickened and enhanced or not. The enhancementpatterns were categorized into four: I=anterior nerve roots enhance only;II=anterior nerve roots enhance stronger than the posterior; III=anteriorand posterior nerve roots enhance equally; IV=posterior nerve roots enhancestronger than the anterior. Statistical analysis was performed to determinethe relationship between different enhancement patterns and clinicalsensory disorder.Results:1、Two doctors considered that5cases had spinal nerve roots and cauda equina thickened, and4cases had no thickened. For the remaining8cases, the coincidence was not achieved.2、MR imaging showed contrast enhancement of the lumbosacral nerveroots and cauda equina in all cases. The enhancement patterns werecategorized into four: I=anterior nerve roots enhance only (4cases,23.5%);II=anterior nerve roots enhance stronger than the posterior (9cases,52.9%);III=anterior and posterior nerve roots enhance equally (3cases,17.6%);IV=posterior nerve roots enhance stronger than the anterior (1cases,5.9%).3、All of the cases had paralysis. Twelve cases had sensory disorder, inwhich2cases were included into type I (anterior nerve roots enhance only)and10cases into type II to IV (both anterior and posterior nerve rootsenhance). The Fisher exact probability test showed that P is0.538, morethan0.05. The trend test showed the chi-square value is1.4796and P is0.2238, more than0.05. The statistical analysis suggested that there is nosignificant difference between the enhancement patterns and with theclinical sensory disorder,Conclusion:1、Spinal enhanced MR imaging is highly valuable in the diagnosis anddifferential diagnosis of GBS.2、The main MR imaging finding of GBS is the contrast enhancementof the spinal nerve roots and cauda equina. The anterior nerve rootsenhance is more frequently detected in most of the cases. 3、The relationship between the enhance patterns of spinal nerve rootsand clinical features needs further study. Designed strictly controlledprospective study is expected to be able to solve this problem.