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Published on: February 28, 2021
Quantitative MRI metrics associated with lesion evolution in myelin oligodendrocyte glycoprotein antibody-associated
Jiali Sun1, Siyao Xu2, Huabing Wang1
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
Objectives:
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is characterized by demyelinating lesions that often resolve on follow-up, but imaging factors associated with lesion resolution remain unclear. Advanced quantitative MRI enables characterization of microstructural alterations and regional perfusion changes within lesions, and our study aimed to identify acute quantitative MRI metrics associated with lesion evolution in MOGAD.
Methods:
MOGAD participants from the Clinical and Imaging Patterns of Neuroinflammation Diseases in China (CLUE) cohort underwent advanced brain MRI within 6 weeks of attack nadir and follow-up MRI beyond 6 months from January 2019 to March 2025. Brain microstructural alterations were assessed using diffusion tensor imaging (DTI) and the advanced diffusion kurtosis imaging (DKI) model, while cerebral perfusion was evaluated using pseudo-continuous arterial spin labeling (pCASL). Imaging parameter ratios were calculated by normalizing lesion values to mirror regions. Generalized estimating equations were used to compare resolving and persistent lesions and assess associations with imaging parameters.
Results:
A total of 105 brain lesions were identified in 21 patients with MOGAD (mean age 34.4 ± 11.6 years; nine women), of which 53 lesions resolved on follow-up MRI. Resolving lesions showed lower axial diffusivity (AD) ratio and higher mean kurtosis (MK), radial kurtosis, and axial kurtosis ratios compared with persistent lesions. The cerebral blood flow (CBF) ratio of resolving lesions was increased than that of persistent lesions. In lesion-level GEE analyses, lower AD ratio z-score, higher MK ratio z-score, and higher CBF ratio z-score were associated with lesion resolution, although the association for MK was attenuated in sensitivity analyses.
Conclusion:
DTI-AD and CBF were associated with lesion evolution in MOGAD, while DKI-MK showed a suggestive association. These findings suggest that relatively preserved microstructure and perfusion may be related to lesion resolution.
