Li Haiqing, Yang Liqin, Wu Zhengyu, Zhou Lei, Bao Yifang, Geng Daoying, Quan Chao, Li Yuxin
Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China; Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China.
Mult Scler Relat Disord. 2020 Aug;43:102167. doi: 10.1016/j.msard.2020.102167. Epub 2020 May 15.
Background The spectrum of imaging features of patients with MOG antibody disease (MOGAD) remains unclear. We aimed to determine the brain MRI features of MOGAD in a Chinese Han cohort and to assess differences in brain MRI features between MOGAD and neuromyelitis optica spectrum disorders (NMOSDs). Methods We retrospectively reviewed the MRI images of 43 patients with MOGAD. As a routine diagnostic approach, all patients underwent serum aquaporin 4 IgG (AQP4-IgG) and MOG-IgG detection via cell-based assays. The topographies and features of brain lesions were independently assessed by two raters. As a comparison, topographies and features of brain lesions were also assessed using neuroimaging characteristics of NMOSDs recommended by the international panel for NMO diagnosis (IPND) in 2015. Results Thirty-five (81.4%) patients were found to have brain lesions. These brain lesions were classified into the following three patterns according to their distributions: (I) lesions involving midline structures and deep gray matte; (II) supratentorial white matter lesions; and (III) cortical gray matter lesions. There were 17 patients whose brain lesions did not fulfill the neuroimaging characteristics of NMOSDs recommended by the 2015 IPND, in which 11 patients had cortical gray matter lesions and/or juxtacortical white matter lesions, four patients had middle cerebral peduncles lesions, and two patients had gray matter lesions and juxtacortical white matter lesions, as well as middle cerebral peduncles lesions. Conclusion MOGAD in this Chinese Han cohort exhibited distinct brain MRI features, especially in terms of cortical gray matter lesions, juxtacortical white matter lesions, and middle cerebral peduncles lesions, which may help to further identify and diagnose patients with MOGAD while they are waiting for serological antibody results.
髓鞘少突胶质细胞糖蛋白抗体病（MOGAD）患者的影像学特征谱仍不明确。我们旨在确定中国汉族队列中MOGAD的脑部MRI特征，并评估MOGAD与视神经脊髓炎谱系障碍（NMOSD）之间脑部MRI特征的差异。方法：我们回顾性分析了43例MOGAD患者的MRI图像。作为常规诊断方法，所有患者均通过细胞检测法进行血清水通道蛋白4 IgG（AQP4-IgG）和MOG-IgG检测。两名评估者独立评估脑病变的部位和特征。作为对照，还使用2015年国际NMO诊断小组（IPND）推荐的NMOSD神经影像学特征评估脑病变的部位和特征。结果：35例（81.4%）患者发现有脑病变。根据分布情况，这些脑病变分为以下三种类型：（I）累及中线结构和深部灰质的病变；（II）幕上白质病变；（III）皮质灰质病变。有17例患者的脑病变不符合2015年IPND推荐的NMOSD神经影像学特征，其中11例患者有皮质灰质病变和/或皮质下白质病变，4例患者有大脑脚病变，2例患者有灰质病变、皮质下白质病变以及大脑脚病变。结论：该中国汉族队列中的MOGAD表现出独特的脑部MRI特征，尤其是在皮质灰质病变、皮质下白质病变和大脑脚病变方面，这可能有助于在等待血清学抗体结果时进一步识别和诊断MOGAD患者。
