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<meta name="DC.Title" content="Imaging Differences between Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis: A Multi-Institutional Study in Japan" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5663" />
<meta name="DC.Date" content="2018-07-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2018 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Both clinical and imaging criteria must be met to diagnose neuromyelitis optica spectrum disorders and multiple sclerosis. However, neuromyelitis optica spectrum disorders are often misdiagnosed as MS because of an overlap in MR imaging features. The purpose of this study was to confirm imaging differences between neuromyelitis optica spectrum disorders and MS with visually detailed quantitative analyses of large-sample data.

MATERIALS AND METHODS: We retrospectively examined 89 consecutive patients with neuromyelitis optica spectrum disorders (median age, 51 years; range, 16–85 years; females, 77; aquaporin 4 immunoglobulin G–positive, 93%) and 89 with MS (median age, 36 years; range, 18–67 years; females, 68; relapsing-remitting MS, 89%; primary-progressive MS, 7%; secondary-progressive MS, 2%) from 9 institutions across Japan (April 2008 to December 2012). Two neuroradiologists visually evaluated the number, location, and size of all lesions using the Mann-Whitney U test or the Fisher exact test.

RESULTS: We enrolled 79 patients with neuromyelitis optica spectrum disorders and 87 with MS for brain analysis, 57 with neuromyelitis optica spectrum disorders and 55 with MS for spinal cord analysis, and 42 with neuromyelitis optica spectrum disorders and 14 with MS for optic nerve analysis. We identified 911 brain lesions in neuromyelitis optica spectrum disorders, 1659 brain lesions in MS, 86 spinal cord lesions in neuromyelitis optica spectrum disorders, and 102 spinal cord lesions in MS. The frequencies of periventricular white matter and deep white matter lesions were 17% and 68% in neuromyelitis optica spectrum disorders versus 41% and 42% in MS, respectively (location of brain lesions, P &lt; .001). We found a significant difference in the distribution of spinal cord lesions between these 2 diseases ( P = .024): More thoracic lesions than cervical lesions were present in neuromyelitis optica spectrum disorders (cervical versus thoracic, 29% versus 71%), whereas they were equally distributed in MS (46% versus 54%). Furthermore, thoracic lesions were significantly longer than cervical lesions in neuromyelitis optica spectrum disorders ( P = .001), but not in MS ( P = .80).

CONCLUSIONS: Visually detailed quantitative analyses confirmed imaging differences, especially in brain and spinal cord lesions, between neuromyelitis optica spectrum disorders and MS. These observations may have clinical implications.

AQP4-IgG
:   aquaporin 4 immunoglobulin G
BS
:   brain stem
DGM
:   deep gray matter
DWM
:   deep white matter
IQR
:   interquartile range
NMO
:   neuromyelitis optica
NMOSD
:   neuromyelitis optica spectrum disorders
PVWM
:   periventricular white matter
SCWM
:   subcortical white matter" />
<meta name="DC.Contributor" content="H. Tatekawa" />
<meta name="DC.Contributor" content="S. Sakamoto" />
<meta name="DC.Contributor" content="M. Hori" />
<meta name="DC.Contributor" content="Y. Kaichi" />
<meta name="DC.Contributor" content="A. Kunimatsu" />
<meta name="DC.Contributor" content="K. Akazawa" />
<meta name="DC.Contributor" content="T. Miyasaka" />
<meta name="DC.Contributor" content="H. Oba" />
<meta name="DC.Contributor" content="T. Okubo" />
<meta name="DC.Contributor" content="K. Hasuo" />
<meta name="DC.Contributor" content="K. Yamada" />
<meta name="DC.Contributor" content="T. Taoka" />
<meta name="DC.Contributor" content="S. Doishita" />
<meta name="DC.Contributor" content="T. Shimono" />
<meta name="DC.Contributor" content="Y. Miki" />
<meta name="article:published_time" content="2018-07-01" />
<meta name="article:section" content="Adult Brain" />
<meta name="citation_title" content="Imaging Differences between Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis: A Multi-Institutional Study in Japan" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Both clinical and imaging criteria must be met to diagnose neuromyelitis optica spectrum disorders and multiple sclerosis. However, neuromyelitis optica spectrum disorders are often misdiagnosed as MS because of an overlap in MR imaging features. The purpose of this study was to confirm imaging differences between neuromyelitis optica spectrum disorders and MS with visually detailed quantitative analyses of large-sample data.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We retrospectively examined 89 consecutive patients with neuromyelitis optica spectrum disorders (median age, 51 years; range, 16–85 years; females, 77; aquaporin 4 immunoglobulin G–positive, 93%) and 89 with MS (median age, 36 years; range, 18–67 years; females, 68; relapsing-remitting MS, 89%; primary-progressive MS, 7%; secondary-progressive MS, 2%) from 9 institutions across Japan (April 2008 to December 2012). Two neuroradiologists visually evaluated the number, location, and size of all lesions using the Mann-Whitney &lt;i&gt;U&lt;/i&gt; test or the Fisher exact test.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;We enrolled 79 patients with neuromyelitis optica spectrum disorders and 87 with MS for brain analysis, 57 with neuromyelitis optica spectrum disorders and 55 with MS for spinal cord analysis, and 42 with neuromyelitis optica spectrum disorders and 14 with MS for optic nerve analysis. We identified 911 brain lesions in neuromyelitis optica spectrum disorders, 1659 brain lesions in MS, 86 spinal cord lesions in neuromyelitis optica spectrum disorders, and 102 spinal cord lesions in MS. The frequencies of periventricular white matter and deep white matter lesions were 17% and 68% in neuromyelitis optica spectrum disorders versus 41% and 42% in MS, respectively (location of brain lesions, &lt;i&gt;P&lt;/i&gt; &amp;lt; .001). We found a significant difference in the distribution of spinal cord lesions between these 2 diseases (&lt;i&gt;P&lt;/i&gt; = .024): More thoracic lesions than cervical lesions were present in neuromyelitis optica spectrum disorders (cervical versus thoracic, 29% versus 71%), whereas they were equally distributed in MS (46% versus 54%). Furthermore, thoracic lesions were significantly longer than cervical lesions in neuromyelitis optica spectrum disorders (&lt;i&gt;P&lt;/i&gt; = .001), but not in MS (&lt;i&gt;P&lt;/i&gt; = .80).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Visually detailed quantitative analyses confirmed imaging differences, especially in brain and spinal cord lesions, between neuromyelitis optica spectrum disorders and MS. These observations may have clinical implications.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2018/07/01" />
<meta name="citation_mjid" content="ajnr;39/7/1239" />
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<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A5663" />
<meta name="citation_pmid" content="29724765" />
<meta name="citation_volume" content="39" />
<meta name="citation_issue" content="7" />
<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="Adult Brain" />
<meta name="citation_firstpage" content="1239" />
<meta name="citation_lastpage" content="1247" />
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<meta name="citation_author" content="H. Tatekawa" />
<meta name="citation_author_institution" content="aFrom the Department of Diagnostic and Interventional Radiology (H.T., S.S., S.D., T.S., Y.M.), Osaka City University Graduate School of Medicine, Osaka, Japan" />
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<meta name="citation_author" content="M. Hori" />
<meta name="citation_author_institution" content="bDepartment of Radiology (M.H.), Graduate School of Medicine, Juntendo University, Tokyo, Japan" />
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<meta name="citation_author" content="Y. Kaichi" />
<meta name="citation_author_institution" content="cDepartment of Diagnostic Radiology (Y.K.), Graduate School and Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan" />
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<meta name="citation_author" content="A. Kunimatsu" />
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<meta name="citation_author" content="K. Akazawa" />
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<meta name="citation_author" content="T. Miyasaka" />
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<meta name="citation_author" content="H. Oba" />
<meta name="citation_author_institution" content="gDepartment of Radiology (H.O.), Teikyo University School of Medicine, Tokyo, Japan" />
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<meta name="citation_author" content="T. Okubo" />
<meta name="citation_author_institution" content="hDepartment of Radiology (T.O.), Teikyo University Chiba Medical Center, Chiba, Japan" />
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<meta name="citation_author" content="K. Hasuo" />
<meta name="citation_author_institution" content="iDepartment of Diagnostic Radiology (K.H.), National Center for Global Health and Medicine, Tokyo, Japan" />
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<meta name="citation_author" content="K. Yamada" />
<meta name="citation_author_institution" content="eDepartment of Radiology (K.A., K.Y.), Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-8123-3935" />
<meta name="citation_author" content="T. Taoka" />
<meta name="citation_author_institution" content="jDepartment of Radiology (T.T.), Nagoya University Graduate School of Medicine, Nagoya, Japan." />
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<meta name="citation_author" content="S. Doishita" />
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<meta name="citation_author" content="T. Shimono" />
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<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-5847-6587" />
<meta name="citation_author" content="Y. Miki" />
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<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-0621-0044" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=DM. Wingerchuk;citation_author=VA. Lennon;citation_author=SJ. Pittock;citation_title=Revised diagnostic criteria for neuromyelitis optica;citation_pages=1485-1489;citation_volume=66;citation_year=2006;citation_issue=10;citation_pmid=16717206;citation_doi=10.1212/01.wnl.0000216139.44259.74" />
<meta name="citation_reference" content="citation_journal_title=Lancet. Neurology;citation_journal_abbrev=Lancet Neurol;citation_author=DM. Wingerchuk;citation_author=VA. Lennon;citation_author=CF. Lucchinetti;citation_title=The spectrum of neuromyelitis optica.;citation_pages=805-815;citation_volume=6;citation_year=2007;citation_issue=9;citation_pmid=17706564;citation_doi=10.1016/S1474-4422(07)70216-8" />
<meta name="citation_reference" content="citation_journal_title=Annals of neurology;citation_journal_abbrev=Ann Neurol;citation_author=CH. Polman;citation_author=SC. Reingold;citation_author=B. Banwell;citation_title=Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria.;citation_pages=292-302;citation_volume=69;citation_year=2011;citation_issue=2;citation_pmid=21387374;citation_doi=10.1002/ana.22366" />
<meta name="citation_reference" content="citation_journal_title=J Neurol Sci;citation_author=J. Kitley;citation_author=N. Evangelou;citation_author=W. Küker;citation_title=Catastrophic brain relapse in seronegative NMO after a single dose of natalizumab;citation_pages=223-25;citation_volume=339;citation_year=2014;citation_pmid=24576801;citation_doi=10.1016/j.jns.2014.01.035" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_author=L. Matthews;citation_author=R. Marasco;citation_author=M. Jenkinson;citation_title=Distinction of seropositive NMO spectrum disorder and MS brain lesion distribution;citation_volume=80;citation_year=2013;citation_pmid=23486868;citation_doi=10.1212/WNL.0b013e3182887957" />
<meta name="citation_reference" content="citation_journal_title=Journal of clinical neuroscience :  official journal of the Neurosurgical Society of Australasia;citation_journal_abbrev=J Clin Neurosci;citation_author=CE. Pires;citation_author=CM. Silva;citation_author=FC. Lopes;citation_title=Brain MRI abnormalities in Brazilian patients with neuromyelitis optica.;citation_pages=969-974;citation_volume=19;citation_year=2012;citation_issue=7;citation_pmid=22613491;citation_doi=10.1016/j.jocn.2011.10.009" />
<meta name="citation_reference" content="citation_journal_title=Archives of Neurology;citation_journal_abbrev=Arch Neurol;citation_author=SJ. Pittock;citation_author=VA. Lennon;citation_author=K. Krecke;citation_title=Brain abnormalities in neuromyelitis optica.;citation_pages=390-396;citation_volume=63;citation_year=2006;citation_issue=3;citation_pmid=16533966;citation_doi=10.1001/archneur.63.3.390" />
<meta name="citation_reference" content="citation_journal_title=Lancet Neurol;citation_author=MAGNIMS Study Group;citation_title=MRI criteria for the diagnosis of multiple sclerosis: MAGNIMS consensus guidelines;citation_pages=292-303;citation_volume=15;citation_year=2016;citation_pmid=26822746;citation_doi=10.1016/S1474-4422(15)00393-2" />
<meta name="citation_reference" content="citation_journal_title=Mult Scler;citation_author=SY. Huh;citation_author=JH. Min;citation_author=W. Kim;citation_title=The usefulness of brain MRI at onset in the differentiation of multiple sclerosis and seropositive neuromyelitis optica spectrum disorders;citation_volume=20;citation_year=2014;citation_pmid=24072726;citation_doi=10.1177/1352458513506953" />
<meta name="citation_reference" content="citation_journal_title=Mult Scler;citation_author=G. Tackley;citation_author=W. Kuker;citation_author=J. Palace;citation_title=Magnetic resonance imaging in neuromyelitis optica;citation_volume=20;citation_year=2014;citation_pmid=24829291;citation_doi=10.1177/1352458514531087" />
<meta name="citation_reference" content="citation_journal_title=Mult Scler;citation_author=W. Kim;citation_author=MS. Park;citation_author=SH. Lee;citation_title=Characteristic brain magnetic resonance imaging abnormalities in central nervous system aquaporin-4 autoimmunity;citation_volume=16;citation_year=2010;citation_pmid=20685766;citation_doi=10.1177/1352458510376640" />
<meta name="citation_reference" content="citation_journal_abbrev=PLoS ONE;citation_author=Z. Lu;citation_author=B. Zhang;citation_author=W. Qiu;citation_title=Comparative brain stem lesions on MRI of acute disseminated encephalomyelitis, neuromyelitis optica, and multiple sclerosis.;citation_pages=e22766-e22766;citation_volume=6;citation_year=2011;citation_issue=8;citation_pmid=21853047;citation_doi=10.1371/journal.pone.0022766" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_author=T. Sinnecker;citation_author=J. Dörr;citation_author=CF. Pfueller;citation_title=Distinct lesion morphology at 7-T MRI differentiates neuromyelitis optica from multiple sclerosis;citation_volume=79;citation_year=2012;citation_pmid=22855861;citation_doi=10.1212/WNL.0b013e3182648bc8" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_author=International Panel for NMO Diagnosis;citation_title=International consensus diagnostic criteria for neuromyelitis optica spectrum disorders;citation_volume=85;citation_year=2015;citation_pmid=26092914;citation_doi=10.1212/WNL.0000000000001729" />
<meta name="citation_reference" content="citation_journal_title=J Neurol Neurosurg Psychiatry;citation_author=M. Juryńczyk;citation_author=M. Craner;citation_author=J. Palace;citation_title=Overlapping CNS inflammatory diseases: differentiating features of NMO and MS;citation_volume=86;citation_year=2015;citation_pmid=25248365;citation_doi=10.1136/jnnp-2014-308984" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=Y. Miki;citation_author=RI. Grossman;citation_author=JK. Udupa;citation_title=Isolated U-fiber involvement in MS: Preliminary observations;citation_pages=1301-1306;citation_volume=50;citation_year=1998;citation_issue=5;citation_pmid=9595978;citation_doi=10.1212/WNL.50.5.1301" />
<meta name="citation_reference" content="citation_journal_title=Radiology;citation_journal_abbrev=Radiology;citation_author=JJ. Geurts;citation_author=PJ. Pouwels;citation_author=BM. Uitdehaag;citation_title=Intracortical Lesions in Multiple Sclerosis: Improved Detection with 3D Double Inversion-Recovery MR Imaging;citation_pages=254-260;citation_volume=236;citation_year=2005;citation_issue=1;citation_pmid=15987979;citation_doi=10.1148/radiol.2361040450" />
<meta name="citation_reference" content="citation_journal_title=AJNR Am J Neuroradiol;citation_author=A. Mike;citation_author=BI. Glanz;citation_author=P. Hildenbrand;citation_title=Identification and clinical impact of multiple sclerosis cortical lesions as assessed by routine 3T MR imaging;citation_volume=32;citation_year=2011;citation_pmid=21310857;citation_doi=10.3174/ajnr.A2340" />
<meta name="citation_reference" content="citation_journal_title=American Journal of Neuroradiology;citation_journal_abbrev=Am. J. Neuroradiol.;citation_author=AL. Horowitz;citation_author=RD. Kaplan;citation_author=G. Grewe;citation_title=The ovoid lesion: a new MR observation in patients with multiple sclerosis.;citation_pages=303-305;citation_volume=10;citation_year=1989;citation_issue=2;citation_pmid=2494849" />
<meta name="citation_reference" content="citation_journal_title=Acta neurologica Scandinavica;citation_journal_abbrev=Acta Neurol Scand;citation_author=MA. Sahraian;citation_author=EW. Radue;citation_author=S. Haller;citation_title=Black holes in multiple sclerosis: definition, evolution, and clinical correlations.;citation_pages=1-8;citation_volume=122;citation_year=2010;citation_issue=1;citation_pmid=20003089;citation_doi=10.1111/j.1600-0404.2010.01367.x" />
<meta name="citation_reference" content="citation_journal_title=Radiology;citation_journal_abbrev=Radiology;citation_author=S. Palmer;citation_author=WG. Bradley;citation_author=DY. Chen;citation_title=Subcallosal Striations: Early Findings of Multiple Sclerosis on Sagittal, Thin-Section, Fast FLAIR MR Images;citation_pages=149-153;citation_volume=210;citation_year=1999;citation_issue=1;citation_pmid=9885600;citation_doi=10.1148/radiology.210.1.r99ja38149" />
<meta name="citation_reference" content="citation_journal_title=American Journal of Neuroradiology;citation_journal_abbrev=Am. J. Neuroradiol.;citation_author=Y. Ge;citation_author=RI. Grossman;citation_author=JS. Babb;citation_title=Dirty-Appearing White Matter in Multiple Sclerosis: Volumetric MR Imaging and Magnetization Transfer Ratio Histogram Analysis;citation_pages=1935-1940;citation_volume=24;citation_year=2003;citation_issue=10;citation_pmid=14625213" />
<meta name="citation_reference" content="citation_journal_title=Brain;citation_author=CF. Lucchinetti;citation_author=RH. Gavrilova;citation_author=I. Metz;citation_title=Clinical and radiographic spectrum of pathologically confirmed tumefactive multiple sclerosis;citation_volume=131;citation_year=2008;citation_pmid=18535080;citation_doi=10.1093/brain/awn098" />
<meta name="citation_reference" content="citation_journal_title=Annals of neurology;citation_journal_abbrev=Ann Neurol;citation_author=S. Ito;citation_author=M. Mori;citation_author=T. Makino;citation_title=&quot;Cloud-like enhancement&quot; is a magnetic resonance imaging abnormality specific to neuromyelitis optica.;citation_pages=425-428;citation_volume=66;citation_year=2009;citation_issue=3;citation_pmid=19798642;citation_doi=10.1002/ana.21753" />
<meta name="citation_reference" content="citation_journal_title=Biometrics;citation_journal_abbrev=Biometrics;citation_author=JR. Landis;citation_author=GG. Koch;citation_title=The measurement of observer agreement for categorical data.;citation_pages=159-174;citation_volume=33;citation_year=1977;citation_issue=1;citation_pmid=843571;citation_doi=10.2307/2529310" />
<meta name="citation_reference" content="citation_journal_title=Brain Pathol;citation_author=CF. Lucchinetti;citation_author=Y. Guo;citation_author=BF. Popescu;citation_title=The pathology of an autoimmune astrocytopathy: lessons learned from neuromyelitis optica;citation_pages=83-97;citation_volume=24;citation_year=2014;citation_pmid=24345222;citation_doi=10.1111/bpa.12099" />
<meta name="citation_reference" content="citation_journal_title=European journal of neurology :  the official journal of the European Federation of Neurological Societies;citation_journal_abbrev=Eur J Neurol;citation_author=JA. Cabrera-Gomez;citation_author=I. Kister;citation_title=Conventional brain MRI in neuromyelitis optica.;citation_pages=812-819;citation_volume=19;citation_year=2012;citation_issue=6;citation_pmid=22040258;citation_doi=10.1111/j.1468-1331.2011.03565.x" />
<meta name="citation_reference" content="citation_journal_title=Radiographics;citation_author=T. Taoka;citation_author=A. Fukusumi;citation_author=T. Miyasaka;citation_title=Structure of the medullary veins of the cerebral hemisphere and related disorders;citation_pages=281-97;citation_volume=37;citation_year=2017;citation_pmid=28076020;citation_doi=10.1148/rg.2017160061" />
<meta name="citation_reference" content="citation_journal_title=Brain;citation_journal_abbrev=Brain;citation_author=MA. Lee;citation_author=S. Smith;citation_author=J. Palace;citation_title=Spatial mapping of T2 and gadolinium-enhancing T1 lesion volumes in multiple sclerosis: evidence for distinct mechanisms of lesion genesis?;citation_pages=1261-1270;citation_volume=122;citation_year=1999;citation_issue=Pt 7;citation_pmid=10388792;citation_doi=10.1093/brain/122.7.1261" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_journal_abbrev=Neurology;citation_author=EC. Tallantyre;citation_author=JE. Dixon;citation_author=I. Donaldson;citation_title=Ultra-high-field imaging distinguishes MS lesions from asymptomatic white matter lesions;citation_pages=534-539;citation_volume=76;citation_year=2011;citation_issue=6;citation_pmid=21300968;citation_doi=10.1212/WNL.0b013e31820b7630" />
<meta name="citation_reference" content="citation_journal_title=J Neurol Neurosurg Psychiatry;citation_author=M. Juryńczyk;citation_author=G. Tackley;citation_author=Y. Kong;citation_title=Brain lesion distribution criteria distinguish MS from AQP4-antibody NMOSD and MOG-antibody disease;citation_volume=88;citation_year=2017;citation_pmid=27951522;citation_doi=10.1136/jnnp-2016-314005" />
<meta name="citation_reference" content="citation_journal_title=Journal of the neurological sciences;citation_journal_abbrev=J Neurol Sci;citation_author=T. Matsushita;citation_author=N. Isobe;citation_author=H. Piao;citation_title=Reappraisal of brain MRI features in patients with multiple sclerosis and neuromyelitis optica according to anti-aquaporin-4 antibody status.;citation_pages=37-43;citation_volume=291;citation_year=2010;citation_issue=1-2;citation_pmid=20122699;citation_doi=10.1016/j.jns.2010.01.009" />
<meta name="citation_reference" content="citation_journal_title=BMC Neurol;citation_author=MF. Liao;citation_author=KH. Chang;citation_author=RK. Lyu;citation_title=Comparison between the cranial magnetic resonance imaging features of neuromyelitis optica spectrum disorder versus multiple sclerosis in Taiwanese patients;citation_pages=218;citation_volume=14;citation_year=2014;citation_pmid=25433369;citation_doi=10.1186/s12883-014-0218-8" />
<meta name="citation_reference" content="citation_journal_title=Lancet. Neurology;citation_journal_abbrev=Lancet Neurol;citation_author=J. Kira;citation_title=Multiple sclerosis in the Japanese population.;citation_pages=117-127;citation_volume=2;citation_year=2003;citation_issue=2;citation_pmid=12849268;citation_doi=10.1016/S1474-4422(03)00308-9" />
<meta name="citation_reference" content="citation_journal_title=J Histochem Cytochem;citation_author=MK. Oklinski;citation_author=JS. Lim;citation_author=HJ. Choi;citation_title=Immunolocalization of water channel proteins AQP1 and AQP4 in rat spinal cord;citation_volume=62;citation_year=2014;citation_pmid=24828513;citation_doi=10.1369/0022155414537495" />
<meta name="citation_reference" content="citation_journal_title=J Neurol Sci;citation_author=C. Dumrikarnlert;citation_author=S. Siritho;citation_author=P. Chulapimphan;citation_title=The characteristics of spinal imaging in different types of demyelinating diseases;citation_pages=138-43;citation_volume=372;citation_year=2017;citation_pmid=28017200;citation_doi=10.1016/j.jns.2016.11.035" />
<meta name="citation_reference" content="citation_journal_title=Neuropathology;citation_author=N. Goto;citation_author=N. Otsuka;citation_title=Development and anatomy of the spinal cord;citation_pages=25-31;citation_volume=17;citation_year=1997;citation_doi=10.1111/j.1440-1789.1997.tb00007.x" />
<meta name="citation_reference" content="citation_journal_title=Brain pathology (Zurich, Switzerland);citation_journal_abbrev=Brain Pathol;citation_author=CP. Gilmore;citation_author=L. Bö;citation_author=T. Owens;citation_title=Spinal cord gray matter demyelination in multiple sclerosis-a novel pattern of residual plaque morphology.;citation_pages=202-208;citation_volume=16;citation_year=2006;citation_issue=3;citation_pmid=16911477;citation_doi=10.1111/j.1750-3639.2006.00018.x" />
<meta name="citation_reference" content="citation_journal_title=Clin Anat;citation_author=CJ. Griessenauer;citation_author=J. Raborn;citation_author=P. Foreman;citation_title=Venous drainage of the spine and spinal cord: a comprehensive review of its history, embryology, anatomy, physiology, and pathology;citation_pages=75-87;citation_volume=28;citation_year=2015;citation_pmid=24677178;citation_doi=10.1002/ca.22354" />
<meta name="citation_reference" content="citation_journal_title=Neurology;citation_author=Y. Liu;citation_author=J. Wang;citation_author=M. Daams;citation_title=Differential patterns of spinal cord and brain atrophy in NMO and MS;citation_volume=84;citation_year=2015;citation_pmid=25762714;citation_doi=10.1212/WNL.0000000000001441" />
<meta name="citation_reference" content="citation_journal_title=Journal of neuro-ophthalmology :  the official journal of the North American Neuro-Ophthalmology Society;citation_journal_abbrev=J Neuroophthalmol;citation_author=S. Khanna;citation_author=A. Sharma;citation_author=J. Huecker;citation_title=Magnetic resonance imaging of optic neuritis in patients with neuromyelitis optica versus multiple sclerosis.;citation_pages=216-220;citation_volume=32;citation_year=2012;citation_issue=3;citation_pmid=22659839;citation_doi=10.1097/WNO.0b013e318254c62d" />
<meta name="citation_reference" content="citation_journal_abbrev=NeuroImage;citation_author=J. Jovicich;citation_author=S. Czanner;citation_author=X. Han;citation_title=MRI-derived measurements of human subcortical, ventricular and intracranial brain volumes: Reliability effects of scan sessions, acquisition sequences, data analyses, scanner upgrade, scanner vendors and field strengths.;citation_pages=177-192;citation_volume=46;citation_year=2009;citation_issue=1;citation_pmid=19233293;citation_doi=10.1016/j.neuroimage.2009.02.010" />
<meta name="citation_reference" content="citation_journal_title=American Journal of Neuroradiology;citation_journal_abbrev=Am. J. Neuroradiol.;citation_author=TA. Yousry;citation_author=M. Filippi;citation_author=C. Becker;citation_title=Comparison of MR pulse sequences in the detection of multiple sclerosis lesions;citation_pages=959-963;citation_volume=18;citation_year=1997;citation_issue=5;citation_pmid=9159377" />
<meta name="citation_reference" content="citation_journal_title=Clin Neurol Neurosurg;citation_author=H. Kataoka;citation_author=T. Kiriyama;citation_author=T. Taoka;citation_title=Comparison of brain 3.0-T with 1.5-T MRI in patients with multiple sclerosis: a 6-month follow-up study;citation_pages=55-58;citation_volume=121;citation_year=2014;citation_pmid=24793476;citation_doi=10.1016/j.clineuro.2014.03.018" />
<meta name="citation_reference" content="citation_journal_title=Journal of neurology;citation_journal_abbrev=J Neurol;citation_author=IL. Tan;citation_author=RA. van Schijndel;citation_author=F. Fazekas;citation_title=Improved interobserver agreement for visual detection of active T2 lesions on serial MR scans in multiple sclerosis using image registration.;citation_pages=789-794;citation_volume=248;citation_year=2001;citation_issue=9;citation_pmid=11596784;citation_doi=10.1007/s004150170095" />
<meta name="citation_fulltext_world_readable" content="" />
<meta name="twitter:title" content="Imaging Differences between Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis: A Multi-Institutional Study in Japan" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Both clinical and imaging criteria must be met to diagnose neuromyelitis optica spectrum disorders and multiple sclerosis. However, neuromyelitis optica spectrum disorders are often misdiagnosed as MS because of an overlap in MR imaging features. The purpose of this study was to confirm imaging differences between neuromyelitis optica spectrum disorders and MS with visually detailed quantitative analyses of large-sample data.

MATERIALS AND METHODS: We retrospectively examined 89 consecutive patients with neuromyelitis optica spectrum disorders (median age, 51 years; range, 16–85 years; females, 77; aquaporin 4 immunoglobulin G–positive, 93%) and 89 with MS (median age, 36 years; range, 18–67 years; females, 68; relapsing-remitting MS, 89%; primary-progressive MS, 7%; secondary-progressive MS, 2%) from 9 institutions across Japan (April 2008 to December 2012). Two neuroradiologists visually evaluated the number, location, and size of all lesions using the Mann-Whitney U test or the Fisher exact test.

RESULTS: We enrolled 79 patients with neuromyelitis optica spectrum disorders and 87 with MS for brain analysis, 57 with neuromyelitis optica spectrum disorders and 55 with MS for spinal cord analysis, and 42 with neuromyelitis optica spectrum disorders and 14 with MS for optic nerve analysis. We identified 911 brain lesions in neuromyelitis optica spectrum disorders, 1659 brain lesions in MS, 86 spinal cord lesions in neuromyelitis optica spectrum disorders, and 102 spinal cord lesions in MS. The frequencies of periventricular white matter and deep white matter lesions were 17% and 68% in neuromyelitis optica spectrum disorders versus 41% and 42% in MS, respectively (location of brain lesions, P &lt; .001). We found a significant difference in the distribution of spinal cord lesions between these 2 diseases ( P = .024): More thoracic lesions than cervical lesions were present in neuromyelitis optica spectrum disorders (cervical versus thoracic, 29% versus 71%), whereas they were equally distributed in MS (46% versus 54%). Furthermore, thoracic lesions were significantly longer than cervical lesions in neuromyelitis optica spectrum disorders ( P = .001), but not in MS ( P = .80).

CONCLUSIONS: Visually detailed quantitative analyses confirmed imaging differences, especially in brain and spinal cord lesions, between neuromyelitis optica spectrum disorders and MS. These observations may have clinical implications.

AQP4-IgG
:   aquaporin 4 immunoglobulin G
BS
:   brain stem
DGM
:   deep gray matter
DWM
:   deep white matter
IQR
:   interquartile range
NMO
:   neuromyelitis optica
NMOSD
:   neuromyelitis optica spectrum disorders
PVWM
:   periventricular white matter
SCWM
:   subcortical white matter" />
<meta name="og-title" property="og:title" content="Imaging Differences between Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis: A Multi-Institutional Study in Japan" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/39/7/1239" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Both clinical and imaging criteria must be met to diagnose neuromyelitis optica spectrum disorders and multiple sclerosis. However, neuromyelitis optica spectrum disorders are often misdiagnosed as MS because of an overlap in MR imaging features. The purpose of this study was to confirm imaging differences between neuromyelitis optica spectrum disorders and MS with visually detailed quantitative analyses of large-sample data.

MATERIALS AND METHODS: We retrospectively examined 89 consecutive patients with neuromyelitis optica spectrum disorders (median age, 51 years; range, 16–85 years; females, 77; aquaporin 4 immunoglobulin G–positive, 93%) and 89 with MS (median age, 36 years; range, 18–67 years; females, 68; relapsing-remitting MS, 89%; primary-progressive MS, 7%; secondary-progressive MS, 2%) from 9 institutions across Japan (April 2008 to December 2012). Two neuroradiologists visually evaluated the number, location, and size of all lesions using the Mann-Whitney U test or the Fisher exact test.

RESULTS: We enrolled 79 patients with neuromyelitis optica spectrum disorders and 87 with MS for brain analysis, 57 with neuromyelitis optica spectrum disorders and 55 with MS for spinal cord analysis, and 42 with neuromyelitis optica spectrum disorders and 14 with MS for optic nerve analysis. We identified 911 brain lesions in neuromyelitis optica spectrum disorders, 1659 brain lesions in MS, 86 spinal cord lesions in neuromyelitis optica spectrum disorders, and 102 spinal cord lesions in MS. The frequencies of periventricular white matter and deep white matter lesions were 17% and 68% in neuromyelitis optica spectrum disorders versus 41% and 42% in MS, respectively (location of brain lesions, P &lt; .001). We found a significant difference in the distribution of spinal cord lesions between these 2 diseases ( P = .024): More thoracic lesions than cervical lesions were present in neuromyelitis optica spectrum disorders (cervical versus thoracic, 29% versus 71%), whereas they were equally distributed in MS (46% versus 54%). Furthermore, thoracic lesions were significantly longer than cervical lesions in neuromyelitis optica spectrum disorders ( P = .001), but not in MS ( P = .80).

CONCLUSIONS: Visually detailed quantitative analyses confirmed imaging differences, especially in brain and spinal cord lesions, between neuromyelitis optica spectrum disorders and MS. These observations may have clinical implications.

AQP4-IgG
:   aquaporin 4 immunoglobulin G
BS
:   brain stem
DGM
:   deep gray matter
DWM
:   deep white matter
IQR
:   interquartile range
NMO
:   neuromyelitis optica
NMOSD
:   neuromyelitis optica spectrum disorders
PVWM
:   periventricular white matter
SCWM
:   subcortical white matter" />
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">July 2018,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1239-1247; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5663 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-61679--61987785261" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">H. Tatekawa </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Diagnostic and Interventional Radiology (H.T., S.S., S.D., T.S., Y.M.), Osaka City University Graduate School of Medicine, Osaka, Japan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.%2BTatekawa%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Tatekawa%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.%2BTatekawa%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8050-4895" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H. Tatekawa</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">S. Sakamoto </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Diagnostic and Interventional Radiology (H.T., S.S., S.D., T.S., Y.M.), Osaka City University Graduate School of Medicine, Osaka, Japan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BSakamoto%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sakamoto%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.%2BSakamoto%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-4671-0342" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Sakamoto</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">M. Hori </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (M.H.), Graduate School of Medicine, Juntendo University, Tokyo, Japan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BHori%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hori%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BHori%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1791-8032" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Hori</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Y. Kaichi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Diagnostic Radiology (Y.K.), Graduate School and Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Y.%2BKaichi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kaichi%20Y&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AY.%2BKaichi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-6213-941X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Y. 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Kunimatsu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Radiology (A.K.), Graduate School of Medicine, University of Tokyo, Tokyo, Japan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BKunimatsu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kunimatsu%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BKunimatsu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7141-2585" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Kunimatsu</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">K. Akazawa </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Radiology (K.A., K.Y.), Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.%2BAkazawa%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Akazawa%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AK.%2BAkazawa%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-3646-1821" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K. 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Miyasaka </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Radiology (T.M.), Nara Medical University, Nara, Japan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.%2BMiyasaka%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Miyasaka%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.%2BMiyasaka%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-0551-0929" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T. 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Oba </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>g</span>Department of Radiology (H.O.), Teikyo University School of Medicine, Tokyo, Japan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.%2BOba%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Oba%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.%2BOba%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7295-5709" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H. 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Hasuo </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>i</span>Department of Diagnostic Radiology (K.H.), National Center for Global Health and Medicine, Tokyo, Japan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.%2BHasuo%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hasuo%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AK.%2BHasuo%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-1247-8768" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K. 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Yamada </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Radiology (K.A., K.Y.), Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.%2BYamada%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yamada%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AK.%2BYamada%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8123-3935" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K. 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Taoka </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>j</span>Department of Radiology (T.T.), Nagoya University Graduate School of Medicine, Nagoya, Japan.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.%2BTaoka%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Taoka%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.%2BTaoka%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-9227-0240" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T. 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The purpose of this study was to confirm imaging differences between neuromyelitis optica spectrum disorders and MS with visually detailed quantitative analyses of large-sample data.</p></div><div id="sec-2" class="subsection"><p id="p-3"><strong>MATERIALS AND METHODS:</strong> We retrospectively examined 89 consecutive patients with neuromyelitis optica spectrum disorders (median age, 51 years; range, 16–85 years; females, 77; aquaporin 4 immunoglobulin G–positive, 93%) and 89 with MS (median age, 36 years; range, 18–67 years; females, 68; relapsing-remitting MS, 89%; primary-progressive MS, 7%; secondary-progressive MS, 2%) from 9 institutions across Japan (April 2008 to December 2012). Two neuroradiologists visually evaluated the number, location, and size of all lesions using the Mann-Whitney <em>U</em> test or the Fisher exact test.</p></div><div id="sec-3" class="subsection"><p id="p-4"><strong>RESULTS:</strong> We enrolled 79 patients with neuromyelitis optica spectrum disorders and 87 with MS for brain analysis, 57 with neuromyelitis optica spectrum disorders and 55 with MS for spinal cord analysis, and 42 with neuromyelitis optica spectrum disorders and 14 with MS for optic nerve analysis. We identified 911 brain lesions in neuromyelitis optica spectrum disorders, 1659 brain lesions in MS, 86 spinal cord lesions in neuromyelitis optica spectrum disorders, and 102 spinal cord lesions in MS. The frequencies of periventricular white matter and deep white matter lesions were 17% and 68% in neuromyelitis optica spectrum disorders versus 41% and 42% in MS, respectively (location of brain lesions, <em>P</em> &lt; .001). We found a significant difference in the distribution of spinal cord lesions between these 2 diseases (<em>P</em> = .024): More thoracic lesions than cervical lesions were present in neuromyelitis optica spectrum disorders (cervical versus thoracic, 29% versus 71%), whereas they were equally distributed in MS (46% versus 54%). Furthermore, thoracic lesions were significantly longer than cervical lesions in neuromyelitis optica spectrum disorders (<em>P</em> = .001), but not in MS (<em>P</em> = .80).</p></div><div id="sec-4" class="subsection"><p id="p-5"><strong>CONCLUSIONS:</strong> Visually detailed quantitative analyses confirmed imaging differences, especially in brain and spinal cord lesions, between neuromyelitis optica spectrum disorders and MS. These observations may have clinical implications.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">AQP4-IgG<span class="def-item-dt-sep"></span></dt><dd>aquaporin 4 immunoglobulin G<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">BS<span class="def-item-dt-sep"></span></dt><dd>brain stem<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">DGM<span class="def-item-dt-sep"></span></dt><dd>deep gray matter<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">DWM<span class="def-item-dt-sep"></span></dt><dd>deep white matter<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">IQR<span class="def-item-dt-sep"></span></dt><dd>interquartile range<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">NMO<span class="def-item-dt-sep"></span></dt><dd>neuromyelitis optica<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">NMOSD<span class="def-item-dt-sep"></span></dt><dd>neuromyelitis optica spectrum disorders<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">PVWM<span class="def-item-dt-sep"></span></dt><dd>periventricular white matter<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">SCWM<span class="def-item-dt-sep"></span></dt><dd>subcortical white matter</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2018 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org" rel="license">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/39/7/1239.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-highlight"><a href="/content/39/7"  class="highlight-image-linked"><img class="highlight-image" src="http://ajnr-stage2.stage.highwire.org/sites/default/files/styles/medium/public/highwire/ajnr/39/7.cover-source.jpg?itok=sa3kXhJ0" alt="American Journal of Neuroradiology: 39 (7)" /></a></div>
  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 39</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 7 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Jul 2018 </div></div>
      
      
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      <div class="highwire-cite-title">Imaging Differences between Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis: A Multi-Institutional Study in Japan</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Tatekawa</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Sakamoto</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Hori</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Kaichi</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Kunimatsu</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Akazawa</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Miyasaka</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Oba</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Okubo</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Hasuo</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Yamada</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Taoka</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Doishita</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Shimono</span></span>, <span class="highwire-citation-author" data-delta="14"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Miki</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jul 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1239-1247; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5663 </span></div>
  
  
  
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      <div class="highwire-cite-title">Imaging Differences between Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis: A Multi-Institutional Study in Japan</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Tatekawa</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Sakamoto</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Hori</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Kaichi</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Kunimatsu</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Akazawa</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Miyasaka</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Oba</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Okubo</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Hasuo</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Yamada</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Taoka</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Doishita</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Shimono</span></span>, <span class="highwire-citation-author" data-delta="14"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Miki</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jul 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1239-1247; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5663 </span></div>
  
  
  
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