儿童髓鞘少突胶质细胞糖蛋白抗体相关疾病首次发作的MRI分析  

MRI Characteristics of Children with First Attack of Myelin Oligodendrocyte Glycoprotein Antibody Associated Diseases

作　　者：汤静[1] 彭彩云[1] 向永华[1] 金科[1] 李晓明[1] TANG Jing;PENG Caiyun;XIANG Yonghua;JIN Ke;LI Xiaoming(Department of Radiology,Hunan Children’s Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院放射科,湖南长沙410007

出　　处：《中国医学影像学杂志》2022年第3期199-204,共6页Chinese Journal of Medical Imaging

摘　　要：目的 探讨儿童髓鞘少突胶质细胞糖蛋白抗体相关疾病(MOGAD)首次发作的MRI特点。资料与方法 回顾性分析2018年5月—2021年2月湖南省儿童医院临床诊断为MOGAD的40例患儿首次发作时头颅、脊髓及视神经MRI表现,患儿首次发作年龄1.2~13.8岁。结果 40例患儿中,37例(92.5%)头颅MRI可见异常病灶,30例为多脑叶受累,24例皮层、皮层下白质及深部白质均受累,额叶(78.4%,29/37)、顶叶(75.7%,28/37)为最常累及的脑叶,扩散加权成像及磁敏感成像无异常,增强扫描无强化或轻度强化。14例(38.9%)脊髓MRI异常,表现为脊髓长节段、不连续稍长T1稍长T2信号影,主要位于中央灰质部位,增强扫描无强化或轻度强化;其中13例胸髓受累,8例颈髓受累。31.0%(9/29)视神经MRI异常,主要表现为单侧(4例)或双侧(4例)视神经稍增粗,T2WI信号增高,1例累及视交叉,增强扫描以视神经鞘及周围脂肪组织强化为特征。结论 MOGAD患儿头颅、脊髓及视神经MRI表现多样,在头颅多表现为皮层、皮层下白质及深部白质的多发稍长T1稍长T2信号影,在脊髓表现为颈胸髓内长节段、不连续中央病灶,累及视神经主要特征为视神经鞘及周围脂肪组织强化。Purpose To investigate the MRI characteristics in the brain, spinal cord and optic nerves of children with myelin oligodendrocyte glycoprotein antibody associated diseases(MOGAD). Methods and Materials Forty patients with MOGAD in Hunan Children’s Hospital from May 2018 to February 2021 were retrospectively enrolled in this study. The characteristics of cranial, spinal cord and optic nerves MRI were further analyzed. The age of the patients at first seizure ranged from 1.2 to 13.8 years. Results Of 40 children,there were 37 patients(92.5%) with abnormal brain on MRI findings, 30 children with multiple anatomical areas involved, 24 cases with cortex, subcortical white matter, and deep white matter involved. The frontal lobe(78.4%, 29/37) and parietal lobe(75.7%, 28/37) were the most frequently involved. Diffusion weighted imaging and susceptibility weighted imaging of all lesions were with no abnormalities and with no enhancement or slight enhancement. There were 14 cases(38.9%) with spinal MRI abnormalities, showing long segment and discontinuous spinal cords with slightly low signal on T1WI and slightly high signal T2WI, mainly located in the central gray matter with no enhancement or slight enhancement. The thoracic spinal cord was most frequently involved(13/40, 92.8%), followed by the cervical spinal cord(8/40, 57.1%).A total of 9 patients showed the abnormal orbital MRI(9/29, 31.0%), mainly presented optic nerves swelling on one side(4 patients) or both sides(4 patients) with increased signal on T2WI. Moreover, the optic chiasm was involved in one patient with the characteristics of enhancement of the optic nerve sheath and surrounding adipose tissue. Conclusion The cranial, spinal, and optic nerves MRI findings in children with MOGAD could be variable, including lesions with multiple slightly low signal on T1WI and slightly high signal on T2WI in the cortex,subcortical white matter and deep white matter. Long segmental and discontinuous central lesions were observed in the cervicothoracic spinal cord, and

关 键 词：髓鞘少突胶质细胞糖蛋白抗体相关疾病 磁共振成像 脊髓 视神经 儿童 

分 类 号：R445.2[医药卫生—影像医学与核医学] R744.5[医药卫生—诊断学]