Marked central canal T2-hyperintensity in MOGAD myelitis and comparison to NMOSD and MS

• Published in: Journal of the neurological sciences Vol. 450; p. 120687
• Main Authors: Webb, Lauren M., Cacciaguerra, Laura, Krecke, Karl N., Chen, John J., Sechi, Elia, Redenbaugh, Vyanka, Dubey, Divyanshu, Pittock, Sean J., Flanagan, Eoin P.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15-07-2023
• Subjects: Adolescent; Adult; Autoantibodies - blood; Bright spotty; Central canal; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; MOG; Multiple sclerosis; Multiple Sclerosis - diagnostic imaging; myelin oligodendrocyte glycoprotein; myelin oligodendrocyte glycoprotein antibody-associated disease; Myelin-Oligodendrocyte Glycoprotein - immunology; Myelitis, Transverse - blood; Myelitis, Transverse - diagnostic imaging; Neuromyelitis optica spectrum disorder; Spinal Canal - diagnostic imaging; Spinal Cord - diagnostic imaging; Young Adult; Multiple sclerosis; Neuromyelitis optica spectrum disorder; MOG; Central canal; MRI; MS; MOGAD; AQP4 + NMOSD; myelin oligodendrocyte glycoprotein antibody-associated disease; CSF; Bright spotty; myelin oligodendrocyte glycoprotein; EDSS
• ISSN: 0022-510X; 1878-5883; 1878-5883
• DOI: 10.1016/j.jns.2023.120687

To assess marked central canal T2-hyperintensity in patients with myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) myelitis compared to myelitis patients with aquaporin-4-antibody-positive neuromyelitis optica spectrum disorder (AQP4 + NMOSD) and multiple sclerosis (MS).
Two blinded raters evaluated spinal cord magnetic resonance imaging (MRIs) of myelitis patients with MOGAD (n = 63), AQP4 + NMOSD (n = 37), and MS (n = 26), assessing for marked central canal T2-hyperintensity and its evolution. If there were conflicting results, a third neurologist assessed the MRI.
Marked central canal T2-hyperintensity was more frequent in patients with MOGAD (18/63[29%]) than MS (1/26[4%]; p = 0.01) myelitis but did not differ from AQP4 + NMOSD (13/37[35%]; p = 0.49). Marked central canal T2-hyperintensity had completely resolved on follow-up axial MRI for most MOGAD (12/14[86%]) and AQP4 + NMOSD (10/10[100%]; p = 0.49) patients.
Marked central canal T2-hyperintensity is a common transient radiologic accompaniment of MOGAD and AQP4 + NMOSD myelitis, but not MS myelitis.
•Marked central canal T2-hyperintensity is common in MOGAD and AQP4 + NMOSD myelitis.•Marked central canal T2-hyperintensity is rare in MS myelitis.•Marked central canal T2-hyperintensity was transient in most patients.•This radiologic finding in myelitis should prompt AQP4-IgG and MOG-IgG testing.