Abstract
Background. Brain lesions are common in neuromyelitis optica spectrum disorder (NMOsd) and may resemble lesions of multiple sclerosis (MS). Objectives. To describe the imaging characteristics of supratentorial lesions in NMOsd on ultrahigh-field (7 T) MRI with special attention to vessel-lesion relationship. Methods. Ten NMOsd patients, all women and all seropositive for NMO IgG, with mean age of 51.3 ± 15.4 years and disease duration of 9.2 ± 6.4 years, were scanned at a 7 T whole-body human MR system with high-resolution 2D gradient echo sequence optimized to best visualize lesions and venous structures, T2- and T1-weighted imaging. Results. In 10 patients with NMOsd, a total of 92 lesions were observed (mean: 9.2 ± 8.8; range: 2–30), but only 8 lesions (9%) were traversed by a central venule. All lesions were <5 mm in diameter, and 83% were located in subcortical white matter. There were no lesions in the cortex or basal ganglia. Two patients exhibited diffuse periependymal abnormalities on FLAIR. Conclusions. Small, subcortical lesions without a central venule are the most consistent finding of NMOsd on 7 T MRI of the brain. Ultrahigh-field imaging may be useful for differentiating between NMOsd and MS.
Highlights
Neuromyelitis optica (NMO) has been traditionally considered a predominantly opticospinal disorder, but recent studies have shown that clinical spectrum of NMO includes cerebral and brainstem syndromes as well [1,2,3]
Ten patients agreed to participate in the study, six of whom were diagnosed with NMO [20] and four with limited forms of NMO
T2-weighted hyperintense lesions on 7 T magnetic resonance imaging (MRI) were observed in all ten neuromyelitis optica spectrum disorder (NMOsd) patients in our cohort
Summary
Neuromyelitis optica (NMO) has been traditionally considered a predominantly opticospinal disorder, but recent studies have shown that clinical spectrum of NMO includes cerebral and brainstem syndromes as well [1,2,3]. Brain lesions on magnetic resonance imaging (MRI) are found in the majority of NMO patients with long-standing disease [1, 2, 4,5,6], which makes it sometimes difficult to differentiate this disorder from multiple sclerosis (MS). Our aim in this work is to characterize brain lesions in patients with neuromyelitis optica spectrum disorders (NMOsd) using 7 T MR and to discuss the ndings in the context of the growing literature on ultrahigh- eld imaging in MS [9,10,11,12,13,14,15,16,17,18,19]. Brain lesions are common in neuromyelitis optica spectrum disorder (NMOsd) and may resemble lesions of multiple sclerosis (MS). Ultrahigh- eld imaging may be useful for differentiating between NMOsd and MS
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