title: Spinal cord diffusion tensor imaging in patients with sensory neuronopathy.
abstract: BACKGROUND
  We investigated whether MR diffusion tensor imaging (DTI) analysis of the cervical spinal cord could aid the (differential) diagnosis of sensory neuronopathies, an underdiagnosed group of diseases of the peripheral nervous system.
  
  
  METHODS
  We obtained spinal cord DTI and T2WI at 3 T from 28 patients, 14 diabetic subjects with sensory-motor distal polyneuropathy, and 20 healthy controls. We quantified DTI-based parameters and looked at the hyperintense T2W signal at the spinal cord posterior columns. Fractional anisotropy and mean diffusivity values at C2-C3 and C3-C4 levels were compared between groups. We also compared average fractional anisotropy (mean of values at C2-C3 and C3-C4 levels). A receiver operating characteristic (ROC) curve was used to determine diagnostic accuracy of average fractional anisotropy, and we compared its sensitivity against the hyperintense signal in segregating patients from the other subjects.
  
  
  RESULTS
  Mean age and disease duration were 52 ± 10 and 11.4 ± 9.3 years in the patient group. Eighteen subjects had idiopathic disease and 6 dysimmune etiology. Fractional anisotropy at C3-C4 level and average fractional anisotropy were significantly different between patients and healthy controls (p < 0.001 and <0.001) and between patients and diabetic subjects (p = 0.019 and 0.027). Average fractional anisotropy presented an area under the curve of 0.838. Moreover, it had higher sensitivity than visual detection of the hyperintense signal (0.86 vs. 0.54), particularly for patients with short disease duration.
  
  
  CONCLUSIONS
  DTI-based analysis enables in vivo detection of posterior column damage in sensory neuronopathy patients and is a useful diagnostic test for this condition. It also helps the differential diagnosis between sensory neuronopathy and distal polyneuropathies.
authors: Department of Neurology, School of Medicine, University of Campinas - UNICAMP, Rua Tessália Vieira de Camargo, 126, Cidade Universitaria "Zeferino Vaz", Campinas, SP, 13083-887, Brazil.|Neurophysics Group, Department of Cosmic Rays and Chronology, Institute of Physics Gleb Wataghin, University of Campinas - UNICAMP, Campinas, SP, Brazil.
authors: Raphael Fernandes
authors: RF
authors: Casseb
authors: Department of Neurology, School of Medicine, University of Campinas - UNICAMP, Rua Tessália Vieira de Camargo, 126, Cidade Universitaria "Zeferino Vaz", Campinas, SP, 13083-887, Brazil.
authors: Jean Levi Ribeiro
authors: JL
authors: de Paiva
authors: Department of Neurology, School of Medicine, University of Campinas - UNICAMP, Rua Tessália Vieira de Camargo, 126, Cidade Universitaria "Zeferino Vaz", Campinas, SP, 13083-887, Brazil.
authors: Lucas Melo Teixeira
authors: LM
authors: Branco
authors: Department of Neurology, School of Medicine, University of Campinas - UNICAMP, Rua Tessália Vieira de Camargo, 126, Cidade Universitaria "Zeferino Vaz", Campinas, SP, 13083-887, Brazil.
authors: Alberto Rolim Muro
authors: AR
authors: Martinez
authors: Department of Radiology, School of Medicine, University of Campinas - UNICAMP, Campinas, SP, Brazil.
authors: Fabiano
authors: F
authors: Reis
authors: Laboratory of Cell Signaling, Department of Internal Medicine, University of Campinas - UNICAMP, Campinas, SP, Brazil.
authors: José Carlos
authors: JC
authors: de Lima-Junior
authors: Neurophysics Group, Department of Cosmic Rays and Chronology, Institute of Physics Gleb Wataghin, University of Campinas - UNICAMP, Campinas, SP, Brazil.
authors: Gabriela
authors: G
authors: Castellano
authors: Department of Neurology, School of Medicine, University of Campinas - UNICAMP, Rua Tessália Vieira de Camargo, 126, Cidade Universitaria "Zeferino Vaz", Campinas, SP, 13083-887, Brazil. mcfrancajr@uol.com.br.
authors: Marcondes Cavalcante França
authors: MC
authors: Junior
mesh_terms: D003937:Diagnosis, Differential; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009443:Neuritis; D011115:Polyneuropathies / Q000175:diagnosis* / Q000473:pathology*; D011843:Radiculopathy / Q000000981:diagnostic imaging* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013116:Spinal Cord / Q000000981:diagnostic imaging* / Q000473:pathology*
keywords: Diffusion tensor imaging (DTI); MRI; Peripheral neuronopathy; Sensory neuronopathy; Spinal cord