MOGAD在MRI上的强化特点
MRI Enhancement Features in Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD)
DOI: 10.12677/acm.2026.162370, PDF,   
作者: 张 鹭, 冯 川*：重庆医科大学附属儿童医院放射科，儿童发育疾病研究教育部重点实验室，儿童发育重大疾病国家国际科技合作基地，儿童代谢与炎症性疾病重庆市重点实验室，重庆
关键词: MOG抗体相关性疾病；增强；视神经炎；脊髓炎；脑炎；MOG Antibody-Associated Disease (MOGAD)； Enhancement； Optic Neuritis； Myelitis； Encephalitis
摘要: MOG抗体相关性疾病(MOGAD)是一种以抗髓鞘少突胶质细胞糖蛋白抗体为特征的自身免疫性中枢神经系统脱髓鞘疾病，其临床表型主要包括视神经炎、脊髓炎和脑炎。MRI增强是诊断与评估MOGAD的重要工具，强化特征可反映活动性炎症与血脑屏障破坏，并可能与疾病预后相关。本文总结了MOGAD在MRI上的强化表现：视神经炎常表现为双侧视神经广泛强化，伴视神经鞘及周围眶内组织强化(神经周围增强)，具有较高特异性；脊髓炎多见于长节段横贯性脊髓炎，轴位可见中央型T2高信号或“H征”，部分伴有软脑膜或脊神经根强化；脑炎强化形式多样，多为斑片状、结节状或线样强化，软脑膜强化亦较常见，而环形强化少见。这些强化特征有助于MOGAD与多发性硬化、水通道蛋白-4抗体相关视神经脊髓炎谱系疾病等相鉴别。准确识别MOGAD的MRI强化模式对于早期诊断、指导治疗及判断预后具有重要意义。
Abstract: Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease (MOGAD) is an autoimmune demyelinating disorder of the central nervous system characterized by antibodies against myelin oligodendrocyte glycoprotein. Its clinical manifestations primarily include optic neuritis, myelitis, and encephalitis. Contrast-enhanced Magnetic Resonance Imaging (MRI) serves as a key tool for diagnosis and evaluation of MOGAD, with enhancement features reflecting active inflammation and blood-brain barrier disruption, which may correlate with disease prognosis. This review summarizes the enhancement patterns of MOGAD on MRI: optic neuritis typically presents with bilateral longitudinally extensive optic nerve enhancement, often accompanied by perineural enhancement involving the optic nerve sheath and surrounding orbital tissues, showing high diagnostic specificity; myelitis commonly manifests as longitudinally extensive transverse myelitis with central T2-hyperintensity on axial images, sometimes exhibiting an “H-sign”, and may be associated with leptomeningeal or spinal nerve root enhancement; encephalitis demonstrates diverse enhancement patterns, including patchy, nodular, or linear enhancement, with leptomeningeal enhancement also frequently observed, whereas ring enhancement is rare. These enhancement characteristics help distinguish MOGAD from multiple sclerosis, aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder, and other demyelinating diseases. Accurate recognition of MRI enhancement patterns in MOGAD is crucial for early diagnosis, guiding treatment decisions, and predicting clinical outcomes.
文章引用：张鹭, 冯川. MOGAD在MRI上的强化特点[J]. 临床医学进展, 2026, 16(2): 131-138. https://doi.org/10.12677/acm.2026.162370

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