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. 2019 Apr:29:15-22.
doi: 10.1016/j.msard.2019.01.021. Epub 2019 Jan 10.

Radiological characteristics of myelin oligodendrocyte glycoprotein antibody disease

Sara Salama  1 , Majid Khan  2 , Michael Levy  3 , Izlem Izbudak  2
Affiliations

Radiological characteristics of myelin oligodendrocyte glycoprotein antibody disease

Sara Salama et al. Mult Scler Relat Disord. 2019 Apr.

Abstract

Background: MOG antibody disease is an autoimmune disease of the central nervous system (CNS) characterized by the presence of a serological antibody against myelin oligodendrocyte glycoprotein (MOG). MRI is instrumental in distinguishing neuromyelitis optica spectrum disorder (NMOSD) from multiple sclerosis (MS), but MRI features of MOG disease appear to overlap with NMOSD and MS.

Objectives: In this study we aim to characterize the radiological features of MOG antibody disease and compare the findings with those previously described.

Methods: This is a retrospective study of 26 MOG positive patients. We aim to describe their brain, spinal and orbital MRI features and compare our findings with those previously reported in the literature.

Results: The majority of the abnormal findings was located on orbital MRIs, with more involvement of the anterior structures and bilateral involvement of the optic nerves. Brain abnormalities were distinct from both NMOSD and MS lesions. Spinal cord was the least affected.

Conclusions: This is a dedicated radiological study aiming to characterize the features of MOG antibody disease which might aid in the proper investigation of cases presenting with acquired demyelinating disorders.

Keywords: MOG antibody; Magnetic resonance imaging; NMOSD.

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Figures

Figure 1.
Figure 1.
Axial FLAIR and axial post contrast brain MRI with FLAIR image showing increased leptomeningeal signal on the right with linear enhancement seen within the sulci on post contrast image.
Figure 2.
Figure 2.
A: Axial T2-weighted image showing confluent deep white matter hyperintensities extending from subcortical to periventricular white matter in a patient presenting with an encephalopathic clinical picture. B: Axial T1 post contrast image showing avid nodular enhancement pattern.
Figure 3.
Figure 3.
Sagittal and 3 axial T2 cervical spine MRIs; showing varying degrees of hyperintense signal changes in a longitudinally extensive pattern and sagittal post contrast T1 cervical spine MR image showing focal contrast enhancement at C6–7 level during acute MOG positive myelitis.
Figure 4.
Figure 4.
Coronal fat saturated T2, axial and coronal fat saturated contrast-enhanced T1 weighted images of the orbits showing bilateral longitudinally extensive acute optic neuritis with T2 hyperintense signal, enlargement and contrast enhancement of the optic nerves in orbital and canalicular segments in a MOG positive patient.
Figure 5:
Figure 5:
summary of findings in patients who underwent brain MRIs.
Figure 6:
Figure 6:
summary of findings in patients who underwent spinal MRIs
Figure 7:
Figure 7:
summary of findings in patients who underwent orbital MRIs.
See this image and copyright information in PMC

References

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