成人期与儿童期发病MOGAD患者脑内病灶分布特点的MRI分析

Spatial characteristic analysis of brain lesions in MOGAD patients in adulthood and childhood by MRI

目的通过MRI评价MOGAD患者的脑内病灶分布特点,探讨儿童期与成人期发病患者之间脑内病变受累的空间差异。方法选取63例我院确诊为MOGAD的患者,收集其临床及影像学资料,根据发病年龄不同分为儿童期发病组(<14岁)和成人期发病组(≥14岁)。分析患者脑内病灶的分布位置,进行统计学分析。结果儿童期发病组39例、成人期发病组24例;首次发病年龄分别为(7.2±2.9)岁、(29.4±15.7)岁。儿童期发病组深部白质受累比例(13/39)明显高于成人期发病组(2/24),两组差异具有统计学意义(P=0.033)。成人期发病组中脊髓炎型比例(9/24),基底节区、大脑脚同时受累的比例(5/24)明显高于儿童期发病组,两组间差异具有统计学意义(P=0.022;P=0.026)。结论儿童期和成人期发病MOGAD患者脑内病灶的分布有一定差异,前者深部白质受累比例更高,后者基底节区、大脑脚同时受累比例更高。

Objective To evaluate the distribution characteristics of brain lesions in MOGAD patients by MRI,and to identify the spatial difference of brain lesions in adulthood and childhood.Methods The imaging of 63 patients,diagnosed as MOGAD and hospitalized at our hospital,were retrospectively collected to analyze the cranial MRI materials and the patients were divided into two groups according to the age of first onset,the children group(<14 years old),and the adults group(≥14 years old).Statistical analyses were performed to compare the groups.Results Out of 63 MOGAD patients,there were 39 in the children group,and 24 in the adults group;the first onset ages were(7.2±2.9)years old and(29.4±15.7)years old,respectively.The proportion of deep white matter involvement in the children group(13/39,33.3%)was significantly higher than that of the adults group(2/24,8.3%),and the difference was statistically significant(P=0.033).The proportion of myelitis type and the lesions of basal ganglia and cerebral peduncle involvement simultaneously in the adults group(9/24,37.5%;5/24,20.8%)was significantly higher than that in the children group(4/39,10.3%;1/39,2.6%),and the difference was statistically significant(P=0.022;P=0.026).Conclusion There are some differences in the distribution of brain lesions in the onset of MOGAD patients in both childhood and adulthood,children are likely to have a higher proportion of deep white matter involvement,while adults have a higher proportion of basal ganglia and cerebral peduncle involvement.