MRI in MOGAD
MRI abnormalities in MOGAD can be detected in the brain, the optic
nerve, and/or the spinal cord, and often depending on the clinically
affected anatomical region of the nervous system. On cerebral MRI,
findings in children most commonly reflect signs of ADEM with diffuse,
widespread white matter T2-lesions, while in adults brainstem or
cortical lesions are more common (2). Acute ON can lead to swelling of
the optic nerve and to severe retinal neurodegeneration over time
(67–70). Typical MRI findings of ON in MOGAD are long lesions in the
anterior part of the optic nerve with periorbital enhancement and often
bilateral affection (40). Spinal cord lesions in MOGAD can be visualised
using MRI typically showing LETM affecting mainly the grey matter as
seen as an “H-sign” on axial plane (41). Important differential
disease diagnoses via MRI findings in MOGAD include its distinction from
MS and AQP4-IgG seropositive NMOSD (71,72). The following sections
describe common radiological presentations found in MOGAD, as well as
advanced MRI techniques with the potential to further evaluate central
nervous system changes in these disorders.