Lin Ting-Yi, Chien Claudia, Lu Angelo, Paul Friedemann, Zimmermann Hanna G
Experimental and Clinical Research Center, Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Expert Rev Neurother. 2021 Oct;21(10):1101-1123. doi: 10.1080/14737175.2021.1982697. Epub 2021 Oct 11.
Neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein IgG antibody-associated disorders (MOGAD) comprise two groups of rare neuroinflammatory diseases that cause attack-related damage to the central nervous system (CNS). Clinical attacks are often characterized by optic neuritis, transverse myelitis, and to a lesser extent, brainstem encephalitis/area postrema syndrome. Retinal optical coherence tomography (OCT) is a non-invasive technique that allows for in vivo thickness quantification of the retinal layers. Apart from OCT, magnetic resonance imaging (MRI) plays an increasingly important role in NMOSD and MOGAD diagnosis based on the current international diagnostic criteria. Retinal OCT and brain/spinal cord/optic nerve MRI can help to distinguish NMOSD and MOGAD from other neuroinflammatory diseases, particularly from multiple sclerosis, and to monitor disease-associated CNS-damage.
This article summarizes the current status of imaging research in NMOSD and MOGAD, and reviews the clinical relevance of OCT, MRI and other relevant imaging techniques for differential diagnosis, screening and monitoring of the disease course.
Retinal OCT and MRI can visualize and quantify CNS damage in vivo, improving our understanding of NMOSD and MOGAD pathology. Further efforts on the standardization of these imaging techniques are essential for implementation into clinical practice and as outcome parameters in clinical trials.
视神经脊髓炎谱系障碍(NMOSD)和髓鞘少突胶质细胞糖蛋白IgG抗体相关疾病(MOGAD)是两组罕见的神经炎症性疾病,可导致与发作相关的中枢神经系统(CNS)损伤。临床发作通常以视神经炎、横贯性脊髓炎为特征,在较小程度上还包括脑干脑炎/最后区综合征。视网膜光学相干断层扫描(OCT)是一种非侵入性技术,可对视网膜各层进行活体厚度定量分析。除OCT外,根据当前国际诊断标准,磁共振成像(MRI)在NMOSD和MOGAD诊断中发挥着越来越重要的作用。视网膜OCT以及脑/脊髓/视神经MRI有助于将NMOSD和MOGAD与其他神经炎症性疾病区分开来,尤其是与多发性硬化症区分开来,并监测与疾病相关的中枢神经系统损伤。
本文总结了NMOSD和MOGAD成像研究的现状,并综述了OCT、MRI及其他相关成像技术在疾病鉴别诊断、筛查和病程监测中的临床相关性。
视网膜OCT和MRI能够在活体中可视化并量化中枢神经系统损伤,增进我们对NMOSD和MOGAD病理学的理解。进一步规范这些成像技术对于将其应用于临床实践以及作为临床试验的结果参数至关重要。