血清MOG-IgG阳性成人和儿童患者临床及影像学特征比较分析  

Comparative analysis of clinical and imaging features in serum MOG-IgG positive adult and pediatric patients

作　　者：朱洪基 蒋梅梅 鲁亚楠 卢娟 刘影[1] ZHU Hongji;JIANG Meimei;LU Ya’nan;LU Juan;LIU Ying(Department of Radiology,the First Afiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China;Department of Radiology,the Committee Hospital of Anhui Provincial Party,Hefei 230001,China;Department of Neurology,the First Afiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China;Department of Pediatrics,the First Afiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)影像科,安徽合肥230001 [2]安徽省省直机关医院影像科,安徽合肥230001 [3]中国科学技术大学附属第一医院(安徽省立医院)神经内科,安徽合肥230001 [4]中国科学技术大学附属第一医院(安徽省立医院)儿科,安徽合肥230001

出　　处：《实用放射学杂志》2025年第3期372-375,380,共5页Journal of Practical Radiology

基　　金：安徽省高等学校省级质量工程项目(2022jyxm1844)。

摘　　要：目的 总结分析抗髓鞘少突胶质细胞糖蛋白免疫球蛋白G抗体(MOG-IgG)相关疾病(MOGAD)首次发病患者临床及影像学特征.方法 回顾性分析39例血清 MOG-IgG阳性患者临床及 MRI资料,比较成人组与儿童组的临床特征(前驱感染史、首发症状及临床表型、脑脊液检查、血清抗体水平)以及病变在影像上位置、分布及强化特征之间的差异.结果 视物模糊是最常见首发症状,2组间差异无统计学意义.与成人组相比,儿童组以急性播散性脑脊髓炎(ADEM)的临床表型更常见.脑脊液检查中白细胞、蛋白含量及寡克隆区带(OCB)阳性2组间均无统计学差异.儿童组较成人组更好发于皮层及皮层下白质、深部白质及基底节区.2组间视神经炎发病率差异无统计学意义.脊髓炎以颈胸段好发,中央灰质受累呈"H征".结论 MOGAD临床及影像学特征在不同发病人群中具有一定的差异,正确认识、早期诊断这类疾病,及时检查及治疗有助于改善患者预后.Objective To summarize and analyze the clinical and imaging features in patients with initial onset of anti-myelin oligodendrocyte glycoprotein-IgG(MOG-IgG)associated disease(MOGAD).Methods The clinical and MRI data of 39 patients with serum MOG-IgG positive were analyzed retrospectively.Clinical features(including history of prior infection,initial symptoms and clinical phenotypes,cerebrospinal fluid examination,and serum antibody levels)and location,distribution,and enhancement patterns of lesions were all compared between adult and pediatric groups.Results Blurred vision was the most common initial symptom,with no statistically significant difference between the two groups.Compared to the adult group,the pediatric group more frequently presented with acute disseminated encephalomyelitis(ADEM)as the clinical phenotype.There were no statistically significant differences between the two groups in cerebrospinal fluid examination results,including leukocyte count,protein content,and oligoclonal bands(OCB)positive.The pediatric group showed a higher prevalence of lesions in the cortical and subcortical white matter,deep white matter,and basal ganglia regions compared with the adult group.There was no statistically significant difference in the incidence of optic neuritis between the two groups.Spinal cord inflammation predominantly affected the cervical and thoracic segments,with central gray matter involvement presenting as the“H-sign”.Conclusion The clinical and imaging features of MOGAD exhibit certain variations across different patient populations.Accurate recognition and early diagnosis of MOGAD and prompt examination and treatment are instrumental in improving patients’prognosis.

关 键 词：成人 儿童 抗髓鞘少突胶质细胞糖蛋白免疫球蛋白G抗体 磁共振成像 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]