Abstract:Objective To investigate MRI features in children with anti-myelin oligodendrocyte glycoprotein-IgG associated disorders (MOGAD). Methods A retrospective case series study was performed. Ten children diagnosed with MOGAD in Liaocheng People's Hospital from January 2018 to December 2021 were enrolled. Among the patients, 6 were males, and 4 were females, with a mean age of 2-9 (5.9±2.4) years. All 10 children underwent routine cerebral MRI scans, 9 underwent routine full-spinal MRI scans, and 4 underwent routine orbital MRI scans before treatment. The detection of MOGAD lesions in the brain, spinal cord, and optic nerve was recorded via MRI. The distribution, morphology, and signal characteristics of brain MOGAD lesions were evaluated. In addition, the lesion site and swelling of the spinal cord were evaluated, and the number of children with a long-segment MOGAD lesion was determined. The lesion site and swelling of the optic nerve were also evaluated, and MRI images of the last follow-up examination were compared with those taken before treatment to observe the outcome of the disease. Results MRI before treatment revealed the following points. (1) The MRI showed brain lesions in all 10 cases, spinal cord lesions in 5 cases, and optic nerve lesions in 2 cases. (2) Multiple MRI lesions were observed in all 10 cases. Nine cases were bilateral, and one case was unilateral. All of the 10 cases presented an asymmetric distribution, 4 cases involved only the supratentorial area, one case involved only the subtentorial area and 5 cases involved the supratentorial and subtentorial areas. The supratentorial lesions were located in subcortical white matter in 7 cases, in white matter around the lateral ventricle in 7 cases, in the thalamus in 5 cases, in the basal ganglia in 4 cases, in the corpus callosum in 2 cases, and in the lateral cortex in one case. The subtentorial lesions were located in pons in 6 cases, in the cerebellum in 4 cases, and in the midbrain in 2 cases. All 10 cases with MRI lesions showed an amorphous patchy morphology, and 2 cases showed patch-like changes simultaneously; in the 2 cases, the DWI sequence exhibited limited diffusion. (3) MRI showed 5 MOGAD myelopathy cases, all of which were single. Lesions of the thoracic spinal cord were observed in all 5 cases, and lesions of the cervical spinal cord were observed in 4 cases; no lumbar spinal cord involvement was observed, and 2 showed spinal cord swelling. All 5 cases of spinal MOGAD presented long-segment myelopathy. (4) MRI showed MOGAD optic neuropathy in 2 cases, both of which were bilateral. One case involved the whole optic nerve, and the other case involved the anterior optic nerve. The optic chiasma and optic tract were not involved. No swelling of the optic nerve was observed in 2 cases. (5) After treatment, all 10 children improved and were discharged. After discharge, they were followed up for 8-29 (12.9±5.8) months. During the follow-up period, MRI scans were examined regularly, and no recurrence was found. The last MR examination showed that the craniocerebral lesions disappeared in 2 cases; myelopathy disappeared in one case; and the MOGAD lesions in the brain, spinal cord, or optic nerve were reduced in scope or number in the 7 remaining cases. Conclusion In children with MOGAD, brain lesions are the most common, followed by spinal cord and optic nerve lesions. The MRI findings for different parts have certain characteristics. Understanding the imaging features of MOGAD can improve the accuracy of clinical diagnosis of MOGAD in children and provide an important reference for early treatment.
李淑华, 方亚军, 吴明振, 张传臣. 儿童抗髓鞘少突胶质细胞糖蛋白IgG相关疾病的MRI征象分析[J]. 中华解剖与临床杂志, 2023, 28(3): 147-152.
Li Shuhua, Fang Yajun, Wu Mingzhen, Zhang Chuanchen. Analysis of magnetic resonance imaging features in children with anti-myelin oligodendrocyte glycoprotein-IgG associated disorders. Chinese Journal of Anatomy and Clinics, 2023, 28(3): 147-152.
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