Nerve ultrasound score in distinguishing chronic from acute inflammatory demyelinating polyneuropathy

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• 作者：A. Kerasnoudis ; ^{antonis.kerasnoudis@gmail.com" class="auth_mail} ; K. Pitarokoili ^{kalliapit@yahoo.gr" class="auth_mail} ; V. Behrendt ^{volker.behrendt@gmx.net" class="auth_mail} ; R. Gold ^{Ralf.Gold@ruhr-uni-bochum.de" class="auth_mail} ; M.-S. Yoon ^{min-suk.yoon@uni-due.de" class="auth_mail}
• 关键词：Bochum ultrasound score ; Acute inflammatory demyelinating polyneuropathy ; Guillain&ndash ; Barre syndrome ; Chronic inflammatory demyelinating polyneuropathy ; Cross sectional area
• 刊名：Clinical Neurophysiology
• 出版年：March, 2014
• 年：2014
• 卷：125
• 期：3
• 页码：635-641
• 全文大小：623 K

文摘

Objective

Aim of this study was to develop and evaluate the applicability of an ultrasound score (Bochum ultrasound score - BUS) in distinguishing chronic (CIDP) from acute inflammatory demyelinating polyneuropathy (AIDP).

Methods

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Step 1: For the development of BUS 75 healthy-controls, 20 CIDP, 20 AIDP patients underwent US 4.55 卤 3.5 and 3.4 卤 2.91 years, respectively after onset. After comparing the distribution pattern and frequency of pathological US changes between the two study groups, we developed BUS, summarizing the cross sectional area (CSA) of: (1) the ulnar nerve in Guyons鈥?canal, (2) the ulnar nerve in upper-arm, (3) the radial nerve in spiral groove, (4) the sural nerve between the gastrocnemius muscle.

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Step 2: The BUS underwent blinded evaluation in further 10 CIDP, 21 AIDP patients 3.8 卤 2.7 and 2.3 卤 1.5 years, respectively after onset.

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Step 3: The BUS underwent blinded, prospective evaluation in 8 patients with acute/subacute polyradiculoneuropathy (5 CIDP, 3 AIDP) 2.6 卤 1.8 weeks after onset.

Results

The BUS showed a sensitivity of 90% and specificity of 90.4% (positive predictive value, PPV = 81.8%; negative predictive value, NPV = 95%) in distinguishing CIDP from AIDP, when they showed no differences in disease duration (p = 0.0551).In addition, the BUS distinguished subacute-CIDP from AIDP with a sensitivity of 80%, specificity of 100% (PPV = 100%, NPV = 75%).

Conclusion

The BUS seems to allow a reliable distinction of CIDP from AIDP.

Significance

The BUS may be helpful in distinguishing subacute-CIDP from AIDP.