Diffusion Tensor Imaging of Tibial and Common Peroneal Nerves in Patients With Guillain-Barre Syndrome: A Feasibility Study

Background: The development of a noninvasive, objective, and accurate method to assess peripheral nerve disorders in Guillain-Barre syndrome (GBS) is of clinical significance. Diffusion tensor imaging (DTI) has been used to evaluate some peripheral nerve disorders.

Purpose: To investigate the feasibility of DTI in evaluating the peripheral nerve disorders in patients with GBS.

Study type: Case control.

Subjects: Twenty GBS patients and 16 healthy volunteers.

Field strength/sequence: 3.0T, T₁ WI-SE, T₂ WI-SPAIR, DTI; electrophysiology.

Assessment: MRI data were analyzed by two radiologists blindly and independently. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusion coefficient (AD), and radial diffusion coefficient (RD) values of tibial nerve (TN) and common peroneal nerve (CPN) were recorded. Motor nerve conduction velocity (MCV) and motor nerve conduction amplitude of TN and CPN were recorded.

Statistical tests: Intraclass correlation coefficient (ICC), t-test, receiver-operating characteristic (ROC), and area under the curve (AUC) analysis, Pearson correlation coefficient.

Results: The FA and AD values of TN and CPN in the GBS group were significantly lower and the ADC and RD values were higher than those in the controls (P <0.05). The AUC of the FA values (0.970 for TN and 0.927 for CPN) were higher than that of the ADC, AD, and RD values. FA and AD values were positively correlated and ADC, RD values were negatively correlated with MCV and motor nerve conduction amplitude, respectively (P <0.05). The correlations between FA value and electrophysiology parameters were the highest.

Data conclusion: DTI quantitative parameters could evaluate the disorders of peripheral nerves in patients with GBS. A moderate correlation was observed between DTI and electrophysiology parameters.

Level of evidence: 3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:1356-1364.