Screening Power of Short Tau Inversion Recovery Muscle Magnetic Resonance Imaging in Critical Illness Myoneuropathy and Guillain–Barre Syndrome in the Intensive Care Unit
Boby Varkey Maramattom
Critical illness myoneuropathy, Critical illness myoneuropathy and magnetic resonance imaging, Critical illness myopathy, Magnetic resonance imaging, Magnetic resonance imaging critical illness polyneuropathy, Magnetic resonance imaging muscle imaging, Magnetic resonance imaging muscle in intensive care unit
Citation Information :
Maramattom BV. Screening Power of Short Tau Inversion Recovery Muscle Magnetic Resonance Imaging in Critical Illness Myoneuropathy and Guillain–Barre Syndrome in the Intensive Care Unit. Indian J Crit Care Med 2022; 26 (2):204-209.
Introduction: Critical illness myoneuropathy (CIMN) or intensive care unit (ICU)-acquired weakness (AW) is a common cause of weakness in ICU patients. Guillain–Barre syndrome (GBS) is also a common cause of acute neurological weakness in the ICU. It is diagnosed by clinical features, nerve conduction studies (NCS), and muscle/nerve biopsies.
Methods: The short tau inversion recovery (STIR) muscle magnetic resonance (MR) images of seven patients with suspected CIMN and seven GBS patients over a 5-year period from February 2015 till May 2020 were analyzed.
Results: All seven patients with CIMN showed diffuse muscle edema, predominating in the lower limbs. Only one patient with GBS showed abnormal magnetic resonance imaging (MRI) changes (14%) and MRI was normal in 86%. The sensitivity of MRI to detect CIMN was 100%, whereas the specificity was 85.7%. Thus, the positive predictive value (PPV) of MRI in this situation was 87.5% and the negative predictive value (NPV) was 100%.
Conclusion: Muscle STIR imaging may help to differentiate between CIMN and GBS.
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