MRI features of myelin oligodendrocyte glycoprotein antibody disease: a descriptive study—how it differs from neuromyelitis optica spectrum disorders and multiple sclerosis

Background Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is a novel inflammatory demyelinating disease of the central nervous system. This study aims to characterize the MRI features of MOGAD and contrast our results with the findings previously described in the literature and its close differential diagnoses. Results Most of the abnormal findings are in the brainstem followed by supratentorial deep/subcortical white matter and optic nerves. Brain lesions in MOGAD tend to show a pattern that is different from multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). Orbital MRIs show features of bilateral longitudinally extensive optic neuritis predominantly involving the anterior segments. The spinal cord is the least affected and mostly shows longitudinally extensive lesions in the dorsal spine. Conclusions We could identify numerous characteristic radiological features that could help distinguish MOGAD from NMOSD and MS. We hope this study helps clinicians systematically evaluate and manage patients with clinical features of neuroinflammatory diseases.