Details

Autor(en) / Beteiligte

• Buch, D.
• Savatovsky, J.
• Gout, O.
• Vignal, C.
• Deschamps, R.

Titel

Combined brain and anterior visual pathways’ MRIs assist in early identification of neuromyelitis optica spectrum disorder at onset of optic neuritis

Ist Teil von

• Acta neurologica Belgica, 2017-03, Vol.117 (1), p.67-74

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2017

Quelle

MEDLINE

Beschreibungen/Notizen

• Acute optic neuritis (ON) is the initial presentation in half of neuromyelitis optica spectrum disorder (NMO-SD) cases. Our objective was to evaluate accuracy of combined MRIs of the anterior visual pathways and of the brain to correctly identify NMO-SD among patients with acute ON. We performed a retrospective study on patients with acute ON in NMO-SD (16 episodes) and first-event non-NMO-SD (32 episodes). All MRIs included exams of the brain and anterior visual pathways using T2-weighted and post-gadolinium T1-weighted coronal thin slices. Images were reviewed by a neuroradiologist who was blinded to the final diagnosis. There were no multiple sclerosis (MS)-like lesions with dissemination in space (DIS) with NMO-SD (0 vs. 53%, p  < 0.01). Non-NMO-SD ON usually spared the chiasma (3 vs. 44%, p  < 0.01) and the optic tracts (0 vs. 19%, p  < 0.01). Optic nerve lesions were longer [median (range) 26 mm (14–64) vs. 13 mm [8–36], p  < 0.01] and the number of segments involved higher (3 [1–8] vs. 1 [1–4], p  < 0.01) in NMO-SD. Bilateral optic nerve involvement, or involvement of ≥3 segments, or involvement of the chiasma, or optic tracts in the absence of MS-like lesions with DIS were suggestive of NMO-SD with a sensitivity of 69% (CI 95% 41–89) and a specificity of 97% (CI 95% 84–99) ( p  < 0.01). Combining brain and anterior visual pathways’ MRIs seems efficient for detecting acute ON patients who are at high risk for NMO-SD.