Wang J, Fang J, Wang J, Xiong Y, Zhu W
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Clin Radiol. 2025 Feb;81:106764. doi: 10.1016/j.crad.2024.106764. Epub 2024 Nov 29.
This study aimed to summarise and analyse the magnetic resonance imaging (MRI) characteristics of patients with myelin oligodendrocyte glycoprotein-immunoglobulin G-associated disease (MOGAD), and to enhance the accuracy of disease diagnosis and advance scientific research.
A retrospective collection of clinical data from 103 patients with MOGAD was conducted. The distribution and signal characteristics of intracranial lesions on MRI were analysed. Further subgroup statistical analysis based on age was performed to explore differences in lesion locations among different subgroups. Statistical comparisons were made using the χ test or Fisher's exact test, with a significance level of P < 0.05 considered statistically significant.
MRI revealed variable lesion morphologies in patients with MOGAD. Lesions were predominantly located in the cerebral deep white matter (47.6%), subcortical white matter (38.8%), and cortex (38.8%) of the supratentorial region, as well as in the brainstem (35.9%) of the infratentorial region. Notably, there was a significantly higher proportion of juvenile patients with thalamic involvement than adult patients (P = 0.013). Juvenile patients were more likely to have lesions involving both the thalamus and cerebral cortex (P = 0.040), thalamus and deep white matter (P = 0.026), or thalamus and brainstem (P = 0.014). Conversely, lesions involving both the corpus callosum and subcortical white matter were more frequently observed in adult patients, with statistically significant differences (P = 0.046). Contrast-enhanced MRI showed mild enhancement in some lesions, with a half of cases exhibiting leptomeningeal enhancement. One rare case presented extensive thickening and enhancement of the falx cerebri.
The distribution of intracranial lesions on MRI exhibits distinct characteristics. The differences in the spatial distribution of intracranial lesions between juvenile and adult patients suggest that MOGAD may represent a heterogeneous disease spectrum that varies with age.
本研究旨在总结和分析髓鞘少突胶质细胞糖蛋白免疫球蛋白G相关疾病（MOGAD）患者的磁共振成像（MRI）特征，以提高疾病诊断的准确性并推动科研进展。
对103例MOGAD患者的临床资料进行回顾性收集。分析MRI上颅内病变的分布及信号特征。基于年龄进行进一步的亚组统计分析，以探讨不同亚组间病变部位的差异。采用χ检验或Fisher精确检验进行统计学比较，P < 0.05为差异有统计学意义。
MRI显示MOGAD患者的病变形态多样。病变主要位于幕上区域的脑深部白质（47.6%）、皮质下白质（38.8%）和皮质（38.8%），以及幕下区域的脑干（35.9%）。值得注意的是，青少年患者丘脑受累的比例显著高于成年患者（P = 0.013）。青少年患者更易出现累及丘脑和大脑皮质（P = 0.040）、丘脑和深部白质（P = 0.026）或丘脑和脑干（P = 0.014）的病变。相反，成年患者中累及胼胝体和皮质下白质的病变更为常见，差异有统计学意义（P = 0.046）。增强MRI显示部分病变有轻度强化，半数病例有软脑膜强化。1例罕见病例表现为大脑镰广泛增厚和强化。
MRI上颅内病变的分布具有明显特征。青少年和成年患者颅内病变空间分布的差异表明，MOGAD可能代表一种随年龄而异的异质性疾病谱。
