Abstract：
OBJECTIVE: To evaluate the feasibility of proximal nerve MR neurography with diffusion tensor imaging (DTI) for differentiating Charcot-Marie-Tooth (CMT) 1A, CMT2, and healthy controls.
METHODS: The diameters, fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) of L4-L5 nerve roots, femoral nerve (FN), and sciatic nerve (SN) were compared. Receiver operating characteristic (ROC) curve analyses were conducted to evaluate the diagnostic performance. DeLong\'s tests were applied to compare multiple ROC curves. Intraclass correlation coefficients were calculated for interobserver agreement assessment.
RESULTS: The diameters of the L4 nerve root, L5 nerve root, and SN of CMT1A patients were significantly larger than those of CMT2 patients and healthy controls. The FA values of all measured proximal nerves were significantly higher in controls (0.46 ± 0.09, 0.46 ± 0.08, 0.45 ± 0.07, and 0.48 ± 0.08) than in CMT1A patients (0.30 ± 0.09, 0.29 ± 0.06, 0.35 ± 0.08, and 0.29 ± 0.09). The FA values of the L5 nerve root, FN, and SN were significantly higher in controls (0.46 ± 0.08, 0.45 ± 0.07, and 0.48 ± 0.08) than in CMT2 patients (0.36 ± 0.06, 0.34 ± 0.07, and 0.34 ± 0.10). The MD and RD values of the L5 nerve root in CMT1A patients (1.59 ± 0.21 and 1.37 ± 0.21) were higher than those in CMT2 patients (1.31 ± 0.17 and 1.05 ± 0.14). The AUCs of the above parameters ranged from 0.780 to 1.000. For the measurements of nerve diameters, the ICC ranged from 0.91 to 0.97. For the measurements of DTI metrics, the ICC ranged from 0.87 to 0.97.
CONCLUSIONS: MR neurography with DTI is able to differentiate CMT1A patients, CMT2 patients, and healthy controls.
CONCLUSIONS: • MR neurography with diffusion tensor imaging of the L4-5 nerve roots, proximal femoral nerve, and proximal sciatic nerve is able to discriminate CMT1A, CMT2, and healthy controls. • This method provides an alternative for the diagnosis and discrimination of CMT1A and CMT2, which is crucial for clinical management.
METHODS: The diameters, fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) of L4-L5 nerve roots, femoral nerve (FN), and sciatic nerve (SN) were compared. Receiver operating characteristic (ROC) curve analyses were conducted to evaluate the diagnostic performance. DeLong\'s tests were applied to compare multiple ROC curves. Intraclass correlation coefficients were calculated for interobserver agreement assessment.
RESULTS: The diameters of the L4 nerve root, L5 nerve root, and SN of CMT1A patients were significantly larger than those of CMT2 patients and healthy controls. The FA values of all measured proximal nerves were significantly higher in controls (0.46 ± 0.09, 0.46 ± 0.08, 0.45 ± 0.07, and 0.48 ± 0.08) than in CMT1A patients (0.30 ± 0.09, 0.29 ± 0.06, 0.35 ± 0.08, and 0.29 ± 0.09). The FA values of the L5 nerve root, FN, and SN were significantly higher in controls (0.46 ± 0.08, 0.45 ± 0.07, and 0.48 ± 0.08) than in CMT2 patients (0.36 ± 0.06, 0.34 ± 0.07, and 0.34 ± 0.10). The MD and RD values of the L5 nerve root in CMT1A patients (1.59 ± 0.21 and 1.37 ± 0.21) were higher than those in CMT2 patients (1.31 ± 0.17 and 1.05 ± 0.14). The AUCs of the above parameters ranged from 0.780 to 1.000. For the measurements of nerve diameters, the ICC ranged from 0.91 to 0.97. For the measurements of DTI metrics, the ICC ranged from 0.87 to 0.97.
CONCLUSIONS: MR neurography with DTI is able to differentiate CMT1A patients, CMT2 patients, and healthy controls.
CONCLUSIONS: • MR neurography with diffusion tensor imaging of the L4-5 nerve roots, proximal femoral nerve, and proximal sciatic nerve is able to discriminate CMT1A, CMT2, and healthy controls. • This method provides an alternative for the diagnosis and discrimination of CMT1A and CMT2, which is crucial for clinical management.
摘要：
目的：评估近端神经MR神经成像与扩散张量成像（DTI）区分Charcot-Marie-Tooth（CMT）1A的可行性，CMT2和健康对照。
方法：直径，分数各向异性（FA），平均扩散率（MD），轴向扩散率（AD），L4-L5神经根的径向扩散率（RD），股神经（FN），与坐骨神经(SN)进行比较。进行受试者工作特征（ROC）曲线分析以评估诊断性能。采用DeLong检验比较多条ROC曲线。计算了组内相关系数，用于观察者间的一致性评估。
结果：L4神经根的直径，L5神经根，CMT1A患者的SN明显大于CMT2患者和健康对照组。对照组（0.46±0.09、0.46±0.08、0.45±0.07和0.48±0.08）的所有测得的近端神经的FA值均显着高于CMT1A患者（0.30±0.09、0.29±0.06、0.35±0.08和0.29±0.09）。L5神经根的FA值，FN,对照组和SN（0.46±0.08、0.45±0.07和0.48±0.08）明显高于CMT2患者（0.36±0.06、0.34±0.07和0.34±0.10）。CMT1A患者L5神经根的MD和RD值（1.59±0.21和1.37±0.21）高于CMT2患者（1.31±0.17和1.05±0.14）。上述参数的AUC范围为0.780至1.000。为了测量神经直径，ICC的范围为0.91~0.97.对于DTI指标的测量，ICC的范围为0.87~0.97.
结论：MR神经造影与DTI能够区分CMT1A患者，CMT2患者，和健康的控制。
结论：•L4-5神经根扩散张量成像的MR神经成像，股神经近端,坐骨神经近端能够辨别CMT1A，CMT2和健康对照。•该方法为CMT1A和CMT2的诊断和区分提供了替代方案，这对于临床管理至关重要。
方法：直径，分数各向异性（FA），平均扩散率（MD），轴向扩散率（AD），L4-L5神经根的径向扩散率（RD），股神经（FN），与坐骨神经(SN)进行比较。进行受试者工作特征（ROC）曲线分析以评估诊断性能。采用DeLong检验比较多条ROC曲线。计算了组内相关系数，用于观察者间的一致性评估。
结果：L4神经根的直径，L5神经根，CMT1A患者的SN明显大于CMT2患者和健康对照组。对照组（0.46±0.09、0.46±0.08、0.45±0.07和0.48±0.08）的所有测得的近端神经的FA值均显着高于CMT1A患者（0.30±0.09、0.29±0.06、0.35±0.08和0.29±0.09）。L5神经根的FA值，FN,对照组和SN（0.46±0.08、0.45±0.07和0.48±0.08）明显高于CMT2患者（0.36±0.06、0.34±0.07和0.34±0.10）。CMT1A患者L5神经根的MD和RD值（1.59±0.21和1.37±0.21）高于CMT2患者（1.31±0.17和1.05±0.14）。上述参数的AUC范围为0.780至1.000。为了测量神经直径，ICC的范围为0.91~0.97.对于DTI指标的测量，ICC的范围为0.87~0.97.
结论：MR神经造影与DTI能够区分CMT1A患者，CMT2患者，和健康的控制。
结论：•L4-5神经根扩散张量成像的MR神经成像，股神经近端,坐骨神经近端能够辨别CMT1A，CMT2和健康对照。•该方法为CMT1A和CMT2的诊断和区分提供了替代方案，这对于临床管理至关重要。
