Callosal Lesions On Magnetic Resonance Imaging With Multiple Sclerosis,Neuromyelitis Optica Spectrum Disorder And Acute Disseminated Encephalomyelitis

ObjectiveTo clarify the features of callosal lesions on magnetic resonance imaging(MRI)in Multiple sclerosis(MS),neuromyelitis optica spectrum disorders(NMOSD),and acute disseminated encephalomyelitis(ADEM).MethodWe enrolled 159 patients with MS,NMOSD,and ADEM diagnosed at the Second Affiliated Hospital of Zhejiang University School of Medicine from December 2014 to August 2018.All patients showed corpus callosum lesions,including 71 patients in MS,70 patients in NMOSD and 18 patients in ADEM.Chi-squared test(Fisher’s exact test)was used to analyze the data.Characteristics of lesions in corpus callosum,as well as other parts of the brain and spinal cord,were evaluated with 1.5T MRI scanners.The clinical and imaging data were collected.ResultCompared with MS in corpus callosum,NMOSD and ADEM lesions tend to have a diffuse distribution(p<0.001,p<0.001)and blurred margins(p<0.001,p<0.001);NMOSD had less ovoid lesions(p<0.001);and the rostrum and genu lesions were less in ADEM.NMOSD has the most heterogeneous intensity on post-enhancement sequences(p<0.001,p=0.007).Radial-like lesions were relatively rare in ADEM(p=0.010,p<0.001).In addition,compared with intracranial lesions,the lesion features were similar with those of corpus callosum lesions.Comparing with MS and NMOSD,the number of intracranial lesions in ADEM was less than 9(p<0.001,p=0.003).While the periventricular,brainstem,and spinal cord lesions were more common in MS(p=0.012,p=0.013,p=0.042)and NMOSD(p=0.0035,p=0.011,p=0.012).ConclusionMS lesions were most likely focally-localized with clear margins.Radial callosal lesions are characteristic of MS and NMOSD but rarely seen in ADEM.The signal intensities of the lesion were the most heterogeneous in NMOSD.Therefore,the lesion patterns in corpus callosum may serve as a useful clue for correct diagnosis,facilitating early treatment.