Brighter spotty lesions on spinal MRI help differentiate AQP4 antibody-positive NMOSD from MOGAD
Jae‐Won Hyun, Hye Lim Lee, Jae-Hong Park, Jiah Kim, Ju‐Hong Min, Byoung Joon Kim, Seung Woo Kim, Ha Young Shin, So‐Young Huh, Woojun Kim, Ji Won Seo, Ki Hoon Kim, Su‐Hyun Kim, Ho Jin Kim
Abstract
In a large acute myelitis cohort, we aimed to determine whether brighter spotty lesions (BSLs)—using the refined terminology—on spinal magnetic resonance imaging (MRI) help distinguish aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-NMOSD) from myelin oligodendrocyte glycoprotein antibody disease (MOGAD). An experienced neuro-radiologist and two neurologists independently analyzed 133 spinal MRI scans (65 from MOGAD and 68 from AQP4-NMOSD) acquired within 1 month of attacks. BSLs were observed in 18 of 61 (30%) participants with AQP4-NMOSD, while none of 49 participants with MOGAD showed BSL ( p < 0.001). BSL during the acute phase would be useful to differentiate AQP4-NMOSD from MOGAD.