Magnetic resonance imaging of Guillain-Barré syndrome

Abstract

Dear Editor,We read with great interest the article by Yikilmaz andcolleagues, which described features of spinal magneticresonance imaging (MRI) in children with Guillain-Barresyndrome (GBS) and investigated the correlation betweenMRI characteristics and the clinical/laboratory examinations[2]. Their findings are intriguing in that MRI appearspromising as a supplementary modality to conventionaldiagnostic methods of GBS. However, we have someconcerns about this study.In this study, a control group seems missing, althoughthe authors mentioned “All patients and the control groupwere scanned with a 1.5-T clinical MR scanner” in thePatients and Methods only. As a consequence, thespecificity of contrast enhancement in spinal MRI, whichmay differentiate GBS from other diseases with/withoutnerve root involvement, is unavailable. This pitfall of thestudy design might limit the merits of their findings.Therefore, the conclusion that MRI can be used as asupplementary diagnostic modality to clinical and labora-tory findings of GBS should be further confirmed bycontrolled studies in the future.Another concern arising from the research is theenrollment of the study subjects. Since the subjects wereretrospectively selected from patients who were hospitalizedin their center with the diagnosis of GBS between 2005 and2010,weareeagertoknowhowtheauthorscouldaccumulateupto40GBScasesthatunderwentacontrast-enhancedspinalMRI. It is well established that MRI contributes to thediagnosis of GBS by demonstrating anterior and posteriorintrathechal spinal nerve roots [1]. However, the use of MRIespecially contrast-enhanced spinal MRI in GBS is currentlyuncommon. Considering the relatively low incidence of GBSin children and that this was a single-center study, we suspectthat the authors designed and conducted this investigation inaprospectiveway.References