自身免疫性郎飞结病磁共振成像研究进展

doi:10.6040/j.issn.1671-7554.0.2024.1330

摘要/Abstract

摘要： 自身免疫性郎飞结病(autoimmune nodopathies, AN)是一种自身抗体,尤其是结旁蛋白IgG4亚型自身抗体作用于郎飞结引起的脱髓鞘病理改变,从而产生一系列临床表现的周围神经病,又统称为结病或结旁病。目前对于结病/结旁病的研究多聚焦于其临床、病理及免疫学等特征,其诊断也多依赖于抗体检测及脑脊液检查等有创检查。周围神经磁共振成像作为无创检查已越来越多地被用于评估周围神经疾病,通过不断了解不同周围神经疾病的形态学及定量变化,可以更好地理解疾病潜在的病理生理过程,为疾病的诊断及治疗评估提供理论支持。因此,本文就磁共振腰骶丛神经成像在结病/结旁病中的应用做一综述,为临床早期诊断及鉴别诊断提供佐证,为制定精准治疗方案提供依据。

关键词: 磁共振神经成像, 自身免疫性郎飞结病, 慢性炎性脱髓鞘性多发性神经根神经病, 吉兰-巴雷综合征, 抗体

Abstract: Autoimmune nodopathies(AN)is a type of autoimmune disease involving autoantibodies, particularly the lgG4 subtype, that act on demyelinating pathological changes on the node of Ranvier. These changes produce a series of clinical manifestations of peripheral neuropathy, collectively referred to as nodo-paranodopathy. Currently, research on AN primarily focuses on their clinical, pathological, and immunological characteristics. Diagnosis mainly depends on invasive examinations, such as antibody detection and cerebrospinal fluid analysis. Magnetic resonance imaging(MRI)of the peripheral nerves has been increasingly used as a noninvasive method to evaluate peripheral nerve diseases. Focusing on the morphological and quantitative changes of different peripheral nerve diseases continuously can help us better understand the potential pathophysiological processes of these diseases, providing theoretical support for their diagnosis and treatment evaluation. Thus, this article reviews the application of lumbosacral plexus magnetic resonance imaging in AN to provide supporting evidence for early clinical diagnosis, differential diagnosis, and the development of accurate treatment plans.

Key words: Magnetic resonance neurography, Autoimmune nodopathies, Chronic inflammatory demyelinating polyradiculoneuropathy, Guillain-Barre Syndrome, Antibodies

中图分类号:

R445.2

单体晓,杜韦辰,王勤周,李安宁,李春海. 自身免疫性郎飞结病磁共振成像研究进展[J]. 山东大学学报 (医学版), 2025, 63(11): 117-122.

SHAN Tixiao, DU Weichen, WANG Qinzhou, LI Anning, LI Chunhai. Research progress of magnetic resonance imaging in autoimmune nodopathies[J]. Journal of Shandong University (Health Sciences), 2025, 63(11): 117-122.

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