Ontology type: schema:ScholarlyArticle
2016-11-01
AUTHORSD. Buch, J. Savatovsky, O. Gout, C. Vignal, R. Deschamps
ABSTRACTAcute 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. More... »
PAGES67-74
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DOIhttp://dx.doi.org/10.1007/s13760-016-0714-2
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PUBMEDhttps://www.ncbi.nlm.nih.gov/pubmed/27804015
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