Zhongjun Hou, Presenter: Nothing to Disclose

Xiaojun Yu, Abstract Co-Author: Nothing to Disclose

Huimin Jiang, Abstract Co-Author: Nothing to Disclose

Xi Li, Abstract Co-Author: Nothing to Disclose

Bingyi Cao, Abstract Co-Author: Nothing to Disclose

Yaotang Chen, Abstract Co-Author: Nothing to Disclose

Jiao Chen, Abstract Co-Author: Nothing to Disclose

Ling Liu, Abstract Co-Author: Nothing to Disclose

The aim of this study was to analyze the characteristics and limitations of application of Magnetic Resonance Imaging (MRI) in acute Guillain-Barré syndrome in children.

Twenty four cases were studied that met the clinical criteria of acute GBS in children. The course of illness ranged from 4 days to 26 days from the onset of weakness in the limbs.The protein concentration of CSF increased in 19 cases using the quantitative method,while it was normal in another 5 cases.Plain scans of MRI in the spine included both T1WI and T2WI on the sagittal scans and an axial scan of T2WI centering on the medullary conus. After intravenous injection of the contrast, CE-T1WI-FS (Contrast Enhancement of T1 Weighted Imaging with Fat Suppression) was performed on the sagittal, coronal and axial planes. The largest diameter of aggregated clusters of the thickened cauda equina was measured based on the findings of the axial scan in each case.

The axial MRI plain scan centering on the medullary conus showed the positive rate in 37.5%, and normal in the involved cervical and cranial nerves, while CE-T1WI-FS displayed the positive rate in 100% in the cauda equina, 35.7% in the cervical nerves and 50.0% in the cranial nerves. On the coronal plane, the thickened cauda equina exhibited a pattern of hanging strings or cords. Comparing the largest diameter of aggregated clusters of the thickened cauda equina on the axial plane of CE-T1WI-FS with the protein concentration of cerebral spinal fluid (CSF), the correlation coefficient was 0.608, P=0.002.

Centering on the medullary conus, combining plain MRI and CE-T1WI-FS is very sensitive to acute GBS which involves the cauda equina in children. However, underdiagnosis often happens in the involved cervical and cranial nerves of acute GBS. The protein concentration of CSF correlates in medium degree to thickening of the cauda equina.

Through comparison of plain and CE-T1WI-FS scans, we can make sure the scope and degree of the involved cauda equina and other partial spinal nerves in acute GBS in children.

Hou, Z, Yu, X, Jiang, H, Li, X, Cao, B, Chen, Y, Chen, J, Liu, L, MRI Diagnosis of Acute Guillain-Barré Syndrome in Children.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11000314.html