Liu C X, Chen C, Zhong X N, Wang Y G, Yang Y, Li R, Sun X B, Fang L, Peng L S, Qiu W
Department of Neurology, the Third Affiliated Hospital of Sun Yet-sen University, Guangzhou 510630, China.
Department of Radiology, the Third Affiliated Hospital of Sun Yet-sen University, Guangzhou 510630, China.
Zhonghua Yi Xue Za Zhi. 2020 Feb 11;100(5):328-333. doi: 10.3760/cma.j.issn.0376-2491.2020.05.003.
To investigate the magnetic resonance imaging (MRI) characteristics in the brain and spinal cord of Chinese patients with myelin oligodendrocyte glycoprotein antibodies associated diseases (MOGAD). Forty nine MOGAD patients with seropositive MOG-IgG and 58 AQP4-IgG positive patients were enrolled in this study. The characteristics of brain and spinal cord MRI were retrospectively analyzed. There was no significant difference in the proportion of abnormal brain MRI of the two groups (69.4% vs 65.5%, 0.177) , while the proportion of abnormal spinal cord MRI of the AQP4-IgG positive group was significantly higher than that in the MOG-IgG positive group (84.5% vs 36.7%, 0.001) . The proportion of MOG-IgG positive patients with subcortical white matter lesions and large lesions in the brain MRI was significantly higher than that in AQP4-IgG positive group (48.9% vs 13.8%, 0.003, 46.9% vs 12.1%, 0.000) . The longitudinally extensive transverse myelitis in spinal cord MRI of AQP4-IgG positive group was significantly higher than that in the MOG-IgG group (70.7% vs 24.5%, 0.002) . In addition, the proportion of MOG-IgG positive child patients with large lesions in the brain was significantly higher than that in AQP4-IgG positive child patients (76.9% vs 20.0%, 0.047) . Demyelinating MRI lesions caused by MOG-IgG are heterogeneous, and could lead to a wide range of clinical phenotypes which is significantly different from those with AQP4-IgG.
探讨中国髓鞘少突胶质细胞糖蛋白抗体相关疾病(MOGAD)患者脑和脊髓的磁共振成像(MRI)特征。本研究纳入了49例血清MOG-IgG阳性的MOGAD患者和58例AQP4-IgG阳性患者。对脑和脊髓MRI特征进行回顾性分析。两组脑MRI异常比例无显著差异(69.4%对65.5%,P=0.177),而AQP4-IgG阳性组脊髓MRI异常比例显著高于MOG-IgG阳性组(84.5%对36.7%,P=0.001)。MOG-IgG阳性患者脑MRI中皮质下白质病变和大病灶的比例显著高于AQP4-IgG阳性组(48.9%对13.8%,P=0.003;46.9%对12.1%,P=0.000)。AQP4-IgG阳性组脊髓MRI中纵向广泛横贯性脊髓炎的比例显著高于MOG-IgG组(70.7%对24.5%,P=0.002)。此外,MOG-IgG阳性儿童患者脑内大病灶的比例显著高于AQP4-IgG阳性儿童患者(76.9%对20.0%,P=0.047)。MOG-IgG引起的脱髓鞘MRI病变具有异质性,可导致广泛的临床表型,与AQP4-IgG引起的临床表型有显著差异。