The magnetic resonance imaging (MRI) features of intracranial lesions in myelin oligodendrocyte glycoprotein-immunoglobulin G-associated disease (MOGAD)

J Wang; J Fang; J Wang; Y Xiong; W Zhu

doi:10.1016/j.crad.2024.106764

The magnetic resonance imaging (MRI) features of intracranial lesions in myelin oligodendrocyte glycoprotein-immunoglobulin G-associated disease (MOGAD)

Clin Radiol. 2024 Nov 29:81:106764. doi: 10.1016/j.crad.2024.106764. Online ahead of print.

Authors

J Wang¹, J Fang¹, J Wang¹, Y Xiong², W Zhu¹

Affiliations

¹ Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: [email protected].

PMID: 39721318
DOI: 10.1016/j.crad.2024.106764

Abstract

Aim: 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.

Materials and methods: 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 χ² test or Fisher's exact test, with a significance level of P < 0.05 considered statistically significant.

Results: 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.

Conclusion: 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.