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.