Fan Xiao, Li Qi, Li Tingsong, He Xiaoyan, Feng Chuan, Qin Bin, Xu Ye, He Ling
Department of Radiology, the Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, People's Republic of China.
Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Neuropsychiatr Dis Treat. 2022 Aug 26;18:1875-1884. doi: 10.2147/NDT.S372446. eCollection 2022.
Studies suggested that myelin oligodendrocyte glycoprotein antibody-associated disorders (MOGAD) are an isolated group of diseases that are different from multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). The proportion of individuals with MOGAD is higher among children. However, limited data are available on autoimmune antibodies and neuroimaging features in children with MOGAD.
This study retrospectively reviewed 42 children with MOGAD. The clinical, neuroradiological, and cerebrospinal fluid data were compared according to courses and radiological results.
Of the 42 patients, 28 suffered a monophasic course and 14 had a relapsing course. During the follow-up magnetic resonance imaging (MRI), 21 patients had a well-resolved brain condition and another 21 patients showed slight improvement with marked residuals. Most patients with relapse had cortical lesions and a leukodystrophy-like MRI pattern (all < 0.05). Children with poor radiological outcomes have confluent and hazy lesions that involve both cortexes, white matter lesion of >2 cm, and a leukodystrophy-like pattern, as well as cerebral lesions with T1 hypointensity or enhancement and spinal lesions (all < 0.05). The multivariable logistic regression analysis used the aforementioned differential features and showed cerebral enhancement and a leukodystrophy-like pattern as the most effective variations associated with poor radiological outcomes of MOGAD with an area under the curve of 0.875.
MOGAD in children have some radiological features suggestive of clinical courses and radiological outcomes. A good understanding of these differential features can help to give early warnings of disease recurrence or poor radiological improvement and develop subsequent therapeutic strategies.
研究表明，髓鞘少突胶质细胞糖蛋白抗体相关疾病（MOGAD）是一组独立的疾病，与多发性硬化症（MS）和视神经脊髓炎谱系障碍（NMOSD）不同。MOGAD在儿童中的比例更高。然而，关于MOGAD患儿自身免疫抗体和神经影像学特征的数据有限。
本研究回顾性分析了42例MOGAD患儿。根据病程和影像学结果比较临床、神经放射学和脑脊液数据。
42例患者中，28例为单相病程，14例为复发病程。在随访的磁共振成像（MRI）中，21例患者脑部情况得到良好缓解，另外21例患者有轻微改善但仍有明显残留。大多数复发患者有皮质病变和类似脑白质营养不良的MRI表现（均P<0.05）。影像学结果差的患儿有累及双侧皮质的融合性模糊病变、>2 cm的白质病变、类似脑白质营养不良的表现，以及T1低信号或强化的脑部病变和脊髓病变（均P<0.05）。多变量逻辑回归分析使用上述差异特征，显示脑部强化和类似脑白质营养不良的表现是与MOGAD影像学结果差最相关的有效变量，曲线下面积为0.875。
儿童MOGAD有一些提示临床病程和影像学结果的放射学特征。充分了解这些差异特征有助于对疾病复发或影像学改善不佳发出早期预警，并制定后续治疗策略。
