MRI diagnosis of Guillain Barre syndrome / 中华神经医学杂志

ABSTRACT

Objective To analyze the characteristics and limitations of MRI diagnosis of Guillian Barre syndrome. Methods Fifteen patients with Guillian Barre syndrome (14 in acute stage, 1 in chronic stage) were performed MRI plain scans and contrast-enhanced (CE) T1-weighted images (T1WI) with fat saturation to observe the relation between MRI manifestations and clinical characteristic in peripheral nerves in the vertebral canal. Results Eight patients in acute stage appeared cauda equina nerve thickening to a varying degree by MRI plain scan and the involved nerves showed isointensity on T1WI and isointensity or slight hypointensity on T2WI. In the chronic patient, the cauda equina and the spinal nerve at all the levels of the spinal cord showed obvious thickening. CE T1WI indicated partial spinal and canda equina nerves thickening to a varying degree below T8 level in 14 acute stage patients with 2 accompanied by partial cervical nerves thickening and 2 by partial cranial nerves thickening, in the chronic patient, T1WI showed enhancement and thickening of all the spinal nerves, cauda equina and partial cranial nerves. Every patient had a symptom of weakness in lower limb, including 9 paralyses in both limbs. Enhanced MRI displayed pathologic changes in the cauda equina in all the patients, while 7 complained of weakness in both upper limbs with only 3 (43%) defined on MRI and 6 suffered from functional disorder of the cranial nerves with 3 (50%) defined on MRI. Conclusions MRI is a sensitive method to demonstrate the pathological changes of the cauda equina in GBs;however, under-diagnosis can often happen in involvements of the cervical and cranial nerves.