The diagnostic value of quantitative assessment of MR neurography in chronic inflammatory demyelinating polyradiculoneuropathy: a systematic review and meta-analysis

Abstract

Objectives: The purpose of this study was to evaluate the diagnostic value of quantitative magnetic resonance neurography (MRN) in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). We also compared various MRN parameters and determined the best performing one. Methods: Through literature searches in PubMed, Embase, Cochrane, Ovid MEDLINE and ClinicalTtrials.gov until March 1, 2023, we selected studies with the diagnostic performance of MRN in CIDP patients. The pooled estimated sensitivity and specificity of quantitative MRN parameters were determined by a bivariate random-effects model. Subgroup analysis was performed to evaluate the proper quantitative parameters and nerve sites. Results: A total of 14 quantitative MRN studies with 23 results gave a pooled sensitivity of 0.73 (95% CI 0.66–0.79) and a pooled specificity of 0.89 (95% CI 0.84–0.92). The area under the curve (AUC) was 0.89 (95%CI 0.86–0.92). Subgroup analysis of quantitative parameters showed the fractional anisotropy (FA) with the highest sensitivity of 0.85 (95% CI 0.77–0.90) and cross-sectional area (CSA) with the highest specificity of 0.95 (95% CI 0.85–0.99). The pooled correlation coefficient for interobserver agreements was 0.90 (95%CI 0.82–0.95). Conclusion: Quantitative MRN has considerable diagnostic value in CIDP patients with accuracy and reliability. FA and CSA can be promising parameters in the future diagnosis of CIDP patients. Advances in knowledge: This is the first meta-analysis of quantitative MRN in the diagnosis of CIDP.We have selected reliable parameters with cut-off value and provided new insights for subsequent diagnosis of CIDP.