Guillain-Barre syndrome: MR imaging findings of the spine in eight patients

PURPOSE: To evaluate magnetic resonance (MR) imaging findings of the spine in patients with Guillain-Barre syndrome. MATERIALS AND METHODS: MR imaging findings in eight patients (three male, five female; age range, 2-47 years) with Guillain-Barre syndrome were retrospectively reviewed. Guillain-Barre syndrome was diagnosed mainly on the basis of symptoms and also on the basis of supportive ancillary data, such as the results cerebrospinal fluid analysis and electrophysiologic evaluation. In addition, follow-up MR imaging was performed in three patients, who had slight clinical improvement. RESULTS: All patients had thickening of the intrathecal spinal nerve roots and cauda equina, with varying degrees of enhancement on gadolinium-enhanced axial T1-weighted images. Two enhancement patterns were noted. One was enhancement of both the anterior and posterior spinal nerve roots (n = 2); the other was enhancement of the anterior spinal nerve roots only (n = 6). Follow-up MR imaging in the three patients with slight improvement of symptoms revealed that the thickening and the degree of enhancement of the spinal nerve roots were diminished. CONCLUSION: Although the enhancement of the intrathecal spinal nerve roots is not specific to Guillain-Barre syndrome and can be seen in neoplasia and other inflammatory processes, the enhancement of only the anterior spinal nerve roots is strongly suggestive of Guillain-Barre syndrome.