IMPROVEMENT OF NEUROIMAGING METHODS IN THE DIAGNOSIS OF DISEASES OF THE PERIPHERAL NERVOUS SYSTEM

Abstract

Since the involvement of the PNS in the pathological process is common in polyneuropathy , plexitis, ganglionitis , it is advisable to provide information about the features of intrathecal homeostasis. It is known that the brain is protected from the ingress of immune system cells from the periphery by two BBB compartments - the blood-brain barrier between the cerebral vessels and the brain parenchyma and the blood-CSF barrier in the choroid plexus.
The purpose of the study . To conduct a comparative analysis of neuroimaging methods for diagnosing diseases of the peripheral nervous system in children.
Materials and research methods . Magnetic resonance imaging (MRI) of the brain and/or spinal cord was performed for all children ( n = 50) with focal disorders in the neurological status upon admission to the hospital, and subsequently, depending on the dynamics of neurostructural changes, again after 3, 6, 12 months , and then, if necessary, until stabilization or complete regression of changes. MRI was performed on ultra -high-field tomographs 1.5 and 3 Tesla on the Signa tomograph Infiniti Echo - Speed , firms General electric ).
Research results. In the course of the study, it was found that in the majority of children (80%, n=35) with polyneuritis, when examined in the acute period of the disease, focal changes on MRI were detected in the T2-weighted image (WI) and FLAIR-pulse sequence (PI), and in 11.7% (n=14) - only on DWI ( diffusion weighted image) images and were absent on T2-WI and FLAIR-IP.
In 10 patients (8.3%) with polyneuritis, focal changes on MRI were not detected in any of the studied sequences. The presence of a characteristic clinical picture and inflammatory changes in the CSF, as well as the detection of VZV in 7 cases, EBV and enteroviruses in 3 cases , made it possible to diagnose EF, despite the absence of focal changes during MRI. With plexitis in 5 cases, foci were also detected only on DWI in the absence of T2-WI and FLAIR-IP. The ganglionitis patients all had lesions in T2-WI and FLAIR-PI and DWI.
Conclusions . If a patient has chronic persistent herpesvirus infection associated with an unfavorable course of organic brain damage, a genetic examination of patients is recommended to look for mutations in the TNFRSF13B and Toll -like receptor 3 genes, which predispose to immunological deficiency of anti- infective immunity.