MRI criteria distinguishing seropositive NMO spectrum disorder from MS

Abstract

The authors have made a quantitative analysis of the shape and distribution of focal T2 white matter lesions by means of lesion probability maps and voxel-wise analysis to distinguish neuromyelitis optica spectrum disorders (NMOSD) from multiple sclerosis (MS). Forty-four patients with aquaporin-4 (AQP4) antibody-positive NMOSD and 50 patients with relapsing-remitting MS (RRMS) were enrolled, though 3 of the patients with NMOSD with apparent ischemic brain lesions were excluded from the analyses. Sixty-three percent of patients with NMOSD and all the patients with RRMS had brain lesions, with 27% of the patients with NMOSD fulfilling Barkhof criteria for dissemination in space. The authors found that the criteria of at least one T2 lesion in both the inferior temporal lobe white matter and adjacent to the body of the lateral ventricle or either a juxtacortical lesion with U-fiber type morphology or an ovoid lesion perpendicular to the lateral ventricle (Dawson finger) were able to distinguish RRMS from NMOSD with high accuracy.1