RT杂志文章SR电子T1鉴别多发性硬化症与aqp4 -神经脊髓炎视谱障碍和mog -抗体疾病的影像学JF神经病学JO神经病学FD Lippincott Williams & Wilkins SP e308 OP e323 DO 10.1212/WNL.0000000000201465首页签证官100是3 A1罗莎Cortese A1弗兰普拉多卡拉斯科A1卡门病重A1 Alessia比安奇A1华莱士Brownlee A1 Floriana De旧金山A1伊莎贝尔·德·拉巴斯A1 Francesco Grussu A1卢卡斯海德尔A1阿奴雅各A1巴里斯Kanber A1丽丝Magnollay A1 (Richard s . Nicholas A1 Anand旅行A1腻过Yiannakas A1艾哈迈德·t·Toosy A1雅艾尔Hacohen A1弗雷德里克Barkhof A1奥尔加Ciccarelli年2023 UL //www.ez-admanager.com/content/100/3/e308.abstract AB背景和目标复发缓和多发性硬化(名RRMS),首页aquaporin-4 antibody–positive neuromyelitis optica spectrum disorder (AQP4-NMOSD), and myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD) may have overlapping clinical features. There is an unmet need for imaging markers that differentiate between them when serologic testing is unavailable or ambiguous. We assessed whether imaging characteristics typical of MS discriminate RRMS from AQP4-NMOSD and MOGAD, alone and in combination.Methods Adult, nonacute patients with RRMS, APQ4-NMOSD, and MOGAD and healthy controls were prospectively recruited at the National Hospital for Neurology and Neurosurgery (London, United Kingdom) and the Walton Centre (Liverpool, United Kingdom) between 2014 and 2019. They underwent conventional and advanced brain, cord, and optic nerve MRI and optical coherence tomography (OCT).Results A total of 91 consecutive patients (31 RRMS, 30 APQ4-NMOSD, and 30 MOGAD) and 34 healthy controls were recruited. The most accurate measures differentiating RRMS from AQP4-NMOSD were the proportion of lesions with the central vein sign (CVS) (84% vs 33%, accuracy/specificity/sensitivity: 91/88/93%, p < 0.001), followed by cortical lesions (median: 2 [range: 1–14] vs 1 [0–1], accuracy/specificity/sensitivity: 84/90/77%, p = 0.002) and white matter lesions (mean: 39.07 [±25.8] vs 9.5 [±14], accuracy/specificity/sensitivity: 78/84/73%, p = 0.001). The combination of higher proportion of CVS, cortical lesions, and optic nerve magnetization transfer ratio reached the highest accuracy in distinguishing RRMS from AQP4-NMOSD (accuracy/specificity/sensitivity: 95/92/97%, p < 0.001). The most accurate measures favoring RRMS over MOGAD were white matter lesions (39.07 [±25.8] vs 1 [±2.3], accuracy/specificity/sensitivity: 94/94/93%, p = 0.006), followed by cortical lesions (2 [1–14] vs 1 [0–1], accuracy/specificity/sensitivity: 84/97/71%, p = 0.004), and retinal nerve fiber layer thickness (RNFL) (mean: 87.54 [±13.83] vs 75.54 [±20.33], accuracy/specificity/sensitivity: 80/79/81%, p = 0.009). Higher cortical lesion number combined with higher RNFL thickness best differentiated RRMS from MOGAD (accuracy/specificity/sensitivity: 84/92/77%, p < 0.001).Discussion Cortical lesions, CVS, and optic nerve markers achieve a high accuracy in distinguishing RRMS from APQ4-NMOSD and MOGAD. This information may be useful in clinical practice, especially outside the acute phase and when serologic testing is ambiguous or not promptly available.Classification of Evidence This study provides Class II evidence that selected conventional and advanced brain, cord, and optic nerve MRI and OCT markers distinguish adult patients with RRMS from AQP4-NMOSD and MOGAD.9-HPT=9-hole peg test; Ab=antibody; AQP4-NMOSD=aquaporin-4 antibody–positive neuromyelitis optica spectrum disorder; AUC=area under the curve; CBA=cell-based assay; CSA=cross-sectional area; CVS=central vein sign; DTI=diffusion tensor imaging; EDSS=Expanded Disability Status Scale; GCIPL=ganglion cell–inner plexiform layer; MOGAD=myelin oligodendrocyte glycoprotein antibody–associated disease; MTR=magnetization transfer ratio; OCT=optical coherence tomography; RC=regression coefficient; RRMS=relapsing-remitting multiple sclerosis; SWI=susceptibility-weighted imaging; TWT=timed 25-foot walk test