Use of Advanced Magnetic Resonance Imaging Techniques in Neuromyelitis Optica Spectrum Disorder

Abstract

Brain parenchymal lesions are frequently observed on conventional magnetic resonance imaging (MRI) scans of patients with neuromyelitis optica (NMO) spectrum disorder, but the specific morphological and temporal patterns distinguishing them unequivocally from lesions caused by other disorders have not been identified. This literature review summarizes the literature on advanced quantitative imaging measures reported for patients with NMO spectrum disorder, including proton MR spectroscopy, diffusion tensor imaging, magnetization transfer imaging, quantitative MR volumetry, and ultrahigh-field strength MRI. It was undertaken to consider the advanced MRI techniques used for patients with NMO by different specialists in the field.Although quantitative measures such as proton MR spectroscopy or magnetization transfer imaging have not reproducibly revealed diffuse brain injury, preliminary data from diffusionweighted imaging and brain tissue volumetry indicate greater white matter than gray matter degradation. These findings could be confirmed by ultrahigh-field MRI. The use of nonconventional MRI techniques may further our understanding of the pathogenic processes in NMO spectrum disorders and may help us identify the distinct radiographic features corresponding to specific phenotypic manifestations of this disease.

Neurodegeneration in multiple sclerosis and neuromyelitis optica

“…Furthermore, brainstem lesions, cerebellar lesions, extensive WM lesions82 83 or cortical GM lesions84 are seen in some patients with NMO. Brain abnormalities on MRI are present in 60% of patients with NMO,82 and 5–42% of the patients fulfil the Barkhof criteria for MS 83 85…”

Electrodynamics and radiofrequency antenna concepts for human magnetic resonance at 23.5 T (1 GHz) and beyond

“…More than 35.000 7.0 Tesla MR research examinations (1) have already been performed globally, producing valuable data that indicate the value of ultrahigh fields (2)(3)(4)(5)(6)(7)(8). Even if these instruments do not become standard tools in the everyday clinical setting in the very near future, the invaluable new insights they are providing into (patho)physiological processes will be helpful to patients everywhere.…”

Value of the central vein sign at 3T to differentiate MS from seropositive NMOSD

“…[3][4][5] Advanced MRI techniques may provide biomarkers that help the differential diagnosis. 6 Recent studies at 7T have shown that the presence of the central vein sign (CVS) within white matter lesions is a hallmark of MS and differentiates MS from NMOSD. [7][8][9] However, 7T scanners are not routinely available in the clinical setting.…”