Typical CIDP, distal variant CIDP, and anti-MAG antibody neuropathy: An ultra-high frequency ultrasound comparison of nerve structure

Sci Rep. 2024 Feb 26;14(1):4643. doi: 10.1038/s41598-024-54452-8.

Abstract

To date, little is known about the usefulness of ultra-high frequency ultrasound (UHF-US, 50-70 MHz) in clinical practice for the diagnosis of dysimmune neuropathies. We present a prospective study aimed at comparing UHF-US alterations of nerves and fascicles in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), distal CIDP (d-CIDP) and anti-MAG neuropathy and their relationships with clinical and electrodiagnostic (EDX) features. 28 patients were included (twelve CIDP, 6 d-CIDP and 10 anti-MAG) and ten healthy controls. Each patient underwent neurological examination, EDX and UHF-US study of median and ulnar nerves bilaterally. UHF-US was reliable in differentiating immune neuropathies from controls when using mean and/or segmental nerve and/or fascicle cross-sectional area (CSA); furthermore, fascicle ratio (fascicle/nerve CSA) was a reliable factor for differentiating d-CIDP from other types of polyneuropathies. The fascicle CSA appears to be more increased in CIDP and its variant than in anti-MAG neuropathy. UHF-US offers information beyond simple nerve CSA and allows for a better characterization of the different forms of dysimmune neuropathies.

MeSH terms

  • Autoantibodies
  • Humans
  • Myelin-Associated Glycoprotein
  • Neural Conduction
  • Peripheral Nerves / diagnostic imaging
  • Polyneuropathies*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating* / diagnostic imaging
  • Prospective Studies
  • Ulnar Nerve / diagnostic imaging
  • Ultrasonography

Substances

  • Myelin-Associated Glycoprotein
  • Autoantibodies