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Master Thesis

Intérêt de l’IRM haute résolution dans la détection d’une atteinte du nerf oculomoteur chez des patients atteints d’artérite à cellules géantes présentant des troubles oculomoteurs

Abstract : Objective: to determine the sensitivity and specificity of high resolution (HR) MRI for detecting signal abnormalities of cranial nerves in GCA patients presenting with diplopia. Materials and Methods: this IRB-approved retrospective single-center study included GCA patients who underwent 3T HR MRI from December 2014 to January 2020. Two radiologists, blinded to all data, individually analyzed imaging. Discrepancies were resolved by consensus with a senior neuroradiologist. They assessed the presence of enhancement of the 3rd, 4th and/or 6th cranial nerves on post-contrast HR imaging and high-signal intensity on HR T2-WI as well as for the presence of signal abnormalities of extraocular muscles, of the brainstem and of inflammatory changes of the ophthalmic and extracranial arteries. A Fisher’s Exact test was used to compare patients with or without diplopia. Results: 64 patients (42/64 (66%) women and 22/64 (34%) men, mean age 76.3 +/- 8 years) were included. 14/64 (21.9%) presented with diplopia. Third cranial nerve enhancement was detected in 7/8 (87.5%) patients with 3rd cranial nerve impairment, all with a fixed impairment, as compared to no patients with 4th or 6th cranial nerve impairment or to patients without diplopia, p<0.001.Third cranial nerve abnormal high-signal intensity on HR T2-WI was detected in 4/5 (80%) patients with 3rd cranial nerve impairment versus none of other patients, p<0.001. Sensitivity, specificity, predictive positive value and negative predictive value for detecting 3rd cranial nerve signal abnormalities were of 0.88, 1, 1 and 0.99 and 0.8, 1, 1 and 0.98 for post-contrast HR imaging and HR T2-WI, respectively. Conclusions: HR MRI had excellent diagnostic sensitivity and specificity when detecting signal abnormalities of the 3rd cranial nerve in GCA patients presenting with 3rd cranial nerve impairment.
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https://dumas.ccsd.cnrs.fr/dumas-02974437
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Submitted on : Wednesday, October 21, 2020 - 6:30:54 PM
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Sandy Mournet. Intérêt de l’IRM haute résolution dans la détection d’une atteinte du nerf oculomoteur chez des patients atteints d’artérite à cellules géantes présentant des troubles oculomoteurs. Sciences du Vivant [q-bio]. 2020. ⟨dumas-02974437⟩

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