| Objective:To provide abundant and accurate imaging data for early diagnosis and clinical condition monitoring, we discussed the distribution characteristics of lesions in neuromyelitis optica spectrum disorders(NMOSD) by studying magnetic resonance imaging(MRI) characteristics of NMOSD, and analyzed the MRI features of aquaprorins 4-Ig G(AQP4-Ig G) seropositive and seronegative patients in NMOSD. Methods:We conducted a retrospective analysis on 86 patients which parallel MRI diagnosis of NMOSD in the first bethune hospital of jilin university in March 2013 to July 2013. Used Excel to entry patients’ data by recording the patient’s name, gender, date of birth, AQP4- Ig G examination, imaging characteristics. We analyzed NMOSD patients’ age, gender, MRI features. Analyzed MRI characteristic by three parts:(1) collected NMOSD patients’ brain MRI data, analyzed the distribution of brain lesions;(2) collected NMOSD patients’ spinal core MRI data, analyzed of the length of the spinal cord lesions and distribution;(3) analyzed the characteristics of the optic lesions. On the basis of AQP4-Ig G serum NMOSD patients divided into two groups:(1) the AQP4-Ig G seropositive group;(2)the AQP4-Ig G seronegative group. Detection of AQP4-Ig G was used indirect immunofluorescence techniques. We analyzed two groups of patients’ brain MRI lesions and the length of the spinal cord lesions and distribution. SPSS 20.0 is used for statistical data test. Measurement data of this study are not obeying the normal distribution; hence we adopted the median and range description. And we applied Wilcoxon Mann-Whitney test to identify if there is existence of significant difference between AQP4-Ig G seronegative and seropositive patients with spinal cord lesion length. For categorical data, when n≥40 and T≥5, we adopt the basic formula of chi square test; When n≥40 and 1≤T<5, we adopt the correction formula of chi-square test; When n< 40 or T < 1, we adopt Fisher exact probability method. Hypothesis testing in α= 0.05 as the inspection level, with P < 0.05 as there are significant differences. Results:(1) Female is more likely suffered in NMOSD, female and male patients with a ratio of 2.9:1. NMOSD can happen at any age, and 20~69 year-old people have a greater probability of NMOSD disease, the probability reach the peak in 50~59 year-old people. NMOSD patients’ AQP4-Ig G seropositive rate was 62.8%.(2) the incidence of diencephalic lesions surrounding the third ventricles and cerebral aqueduct is 10.3%;the incidence of dorsal brainstem lesions adjacent to the fourth ventricle is 24.1%; the incidence of periependymal lesions surrounding the lateral ventricles is 81%; the incidence of hemispheric white matter lesions is 17.2%; the incidence of lesions involving corticospinal tracts was 3.4%; the incidence of nonspecific lesions is 67.2%; the incidence of cerebellar lesions is 15.5%; the incidence of basal ganglia lesions is 19.0%. The incidence of cervical segment lesions is 76.1%, the incidence of higher thoracic segment lesions is 74.6%, and the incidence of in lower thoracic segment lesions is 38%. Optic nerve lesions were observed in 3 cases on MRI.(3) The incidences of periependymal lesions surrounding the lateral ventricles and long segmental spinal cord lesions are statistically significant differences in AQP4-Ig G seropositive and seronegative patients. Conclusions:(1) Female are more likely suffered in NMOSD disease, it can happen at any age.(2) NMOSD brain lesions can be showed diencephalic lesions surrounding the third ventricles and cerebral aqueduct, dorsal brainstem lesions adjacent to the fourth ventricle, periependymal lesions surrounding the lateral ventricles, hemispheric white matter lesions, corticospinal tracts lesions, cerebella lesions, basal ganglia lesions and nonspecific lesions.(3)Lesions are more likely occurred in cervical segment and higher thoracic segment in NMOSD; long segmental spinal lesions occur frequently in AQP4-Ig G seropositive patients. |
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