Ces radiol. 2022, 76(2):96-104 | DOI: 10.55095/CesRadiol2022/012

Magnetic resonance imaging findings in neuromyelitis optica spectrum disorders and disease associated with antibodies to myelin oligodendrocyte glycoproteinReview article

Manuela Vaněčková¹, Petra Nytrová²

¹ Radiodiagnostická klinika 1. LF UK a VFN, Praha

² Neurologická klinika a Centrum klinických neurověd 1. LF UK a VFN, Praha

Neuromyelitis optica is an autoimmune disease of unknown etiology, characterized by involvement of the optic nerves and spinal cord, the main features of which have been widened to include involvement of the dorsal part of the medulla oblongata (area postrema). The disease primarily involves astrocytes. In MRI, the lesions are mainly in the areas where the water channel - aquaporin 4 is expressed. These are the lesions in the diencephalon, periependymally around the lateral ventricles or ventricle IV. The brain MRI may also show non-specific white matter lesions or pyramidal pathway involvement, which is not associated with increased aquaporin 4 expression. Intramedullary involvement is most often in the form of longitudinal extensive transverse myelitis, when the lesion reaches the height of at least three vertebral bodies. The lesions primarily affect the grey matter, are often extensive and cover more than 50% of the spinal cord area. Optic nerve involvement is typically dorsal, affecting the chiasma and optic tract.
Myelin oligodendrocyte glycoprotein antibody-associated disease is a recently identified autoimmune disease that manifests as CNS demyelination, occurs in both adults and children, and can be both relapsing-remitting and monophasic. MRI features depend on the age of the patient; in children the predominant involvement is as in acute disseminated encephalomyelitis, in adults optic neuritis is the most common sign. Typically, the anterior segment of the optic nerve is affected bilaterally. Another area that may be affected is the spinal cord, where longitudinal extensive transverse myelitis tends to occur; the spinal conus is more commonly affected. In the brain parenchyma, the features tend to be non-specific, with lesions affecting both white and grey matter.

Keywords: magnetic resonance imaging, neuromyelitis optica spectrum disorders, disease associated with antibodies to myelin oligodendrocyte glycoprotein, multiple sclerosis

Grants and funding:

Práce byla podpořena MZ ČR, výzkumným záměrem RVO 64165 a grantem NV 18-04-00168 a ministerstvem školství - Cooperatio (1. LF, Neuroscience).

Accepted: May 1, 2022; Published: June 1, 2022  Show citation