The characteristics of spinal imaging in different types of demyelinating diseases

Background Transverse myelitis is the common presentation in demyelinating conditions. Objective To determine the characteristics of spinal lesions among each type of demyelinating diseases. Methods Medical records and spinal imaging of patients who were [1] older than 18 years, [2] had at least one attack of TM, [3] had available spinal MRI data and [4] were tested for aquaporin-4 antibody were included. Results One hundred and fifty-eight patients were eligible (27 clinically isolated syndrome [CIS], 38 MS, 55 seropositive neuromyelitis optica spectrum disorders [NMOSD], 9 seronegative NMOSD, and 29 idiopathic transverse myelitis [IDD-TM]). All groups showed female preponderance and no difference of age at onset. In each patient group, no significant difference in the mean number of spinal lesions was found. The most common levels of involvement were thoracic in IDD-TM, cervical in CIS and MS, as well as cervico-thoracic in both NMOSD groups. Long extensive TM was the most common finding in both the seropositive and seronegative NMOSD groups compared to the other groups. Peripheral location and < 30% of spinal cord area involvement were the characteristic findings in CIS and MS. Central location and intermediately involved of the cross-sectional cord area were the determinants for the seropositive and seronegative NMOSD groups, respectively. Conclusion Spinal MRI findings can help to differentiate among demyelinating diseases in who presented with TM.