Different features of deep gray matter lesions on MRI among acute disseminated encephalomyelitis, multiple sclerosis, and neuromyelitis optica in adults / 中华神经医学杂志

ABSTRACT

Objective To find out the different features of deep gray matter lesions on magnetic resonance imaging (MRI) among patients with acute disseminated encephalomyelitis (ADEM),multiple sclerosis (MS),and neuromyelitis optica (NMO) in adults.Methods After searching the database,353 adult patients,admitted to our hospital from August 2004 to October 2012 and diagnosed as ADEM,MS,and NMO,were identified.Among them,95 adult patients with ADEM (n=12),MS (n=60) and NMO (n=23) had deep gray matter lesions on MRI were included in our study.Morphological features of deep gray matter lesions,including diameter,quantity and distribution among these patients,were compared.Results The percentage of lesions involved in the thalamus,caudate nucleus and globus pallidus was not significantly different among the three groups (P＞0.05).Putamen was more frequently involved in patients with ADEM than that in patients with MS and NMO (P=0.002 and 0.013,respectively).Hypothalamus was more frequently involved in patients with NMO than that in patients with ADEM and MS (P=0.033 and 0.001,respectively).The diameter of the thalamus lesion in patients with ADEM was significantly larger than that in patients with NMO (P=0.027),but was not significantly different from that in patients with MS (P=0.116); no significant difference between the lesion diameters of patients with MS and NMO was observed (P=0.209).The diameters of the lesions located in the caudate nucleus,globuspallidus,putmen,and hypothalamus were not significantly different among the three groups (P＞0.05).Furthermore,no significant difference was found among the three groups in respect of the symmetry of lesion distribution (P=0.335).Conclusions Thalamus involvement might not be helpful in differentiating ADEM from MS in adults.Putamen involvement might be helpful in differentiating ADEM from MS and NMO.Hypothalamus involvement is specific for NMO.Lesion size is not useful in the differential diagnosis of ADEM,MS,and NMO.