title: Conventional and advanced imaging in neuromyelitis optica.
abstract: Myelitis and optic neuritis are prototypic clinical presentations of both multiple sclerosis and neuromyelitis optica. Once considered a subtype of multiple sclerosis, neuromyelitis optica, is now known to have a discrete pathogenesis in which antibodies to the water channel, aquaporin 4, play a critical role. Timely differentiation of neuromyelitis optica from MS is imperative, determining both prognosis and treatment strategy. Early, aggressive immunosuppression is required to prevent the accrual of severe disability in neuromyelitis optica; conversely, MS-specific therapies may exacerbate the disease. The diagnosis of neuromyelitis optica requires the integration of clinical, MR imaging, and laboratory data, but current criteria are insensitive and exclude patients with limited clinical syndromes. Failure to recognize the expanding spectrum of cerebral MR imaging patterns associated with aquaporin 4 antibody seropositivity adds to diagnostic uncertainty in some patients. We present the state of the art in conventional and nonconventional MR imaging in neuromyelitis optica and review the place of neuroimaging in the diagnosis, management, and research of the condition.
authors.affiliation: From the Sydney Neuroimaging Analysis Centre (Y.B., M.H.B.), Sydney, AustraliaBrain and Mind Research Institute (Y.B., M.G., L.M., M.H.B.), University of Sydney, Sydney, AustraliaDepartment of Medical Imaging and Neurology (Y.B., I.J.S.), St Vincent's Hospital, Sydney, Australia.
authors.forename: Y
authors.initials: Y
authors.lastname: Barnett
authors.affiliation: Department of Medical Imaging and Neurology (Y.B., I.J.S.), St Vincent's Hospital, Sydney, Australia.
authors.forename: I J
authors.initials: IJ
authors.lastname: Sutton
authors.affiliation: Brain and Mind Research Institute (Y.B., M.G., L.M., M.H.B.), University of Sydney, Sydney, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Ghadiri
authors.affiliation: Brain and Mind Research Institute (Y.B., M.G., L.M., M.H.B.), University of Sydney, Sydney, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Masters
authors.affiliation: Buffalo Neuroimaging Analysis Center (R.Z.), Department of Neurology, University of Buffalo, Buffalo, New York.
authors.forename: R
authors.initials: R
authors.lastname: Zivadinov
authors.affiliation: From the Sydney Neuroimaging Analysis Centre (Y.B., M.H.B.), Sydney, AustraliaBrain and Mind Research Institute (Y.B., M.G., L.M., M.H.B.), University of Sydney, Sydney, Australia michael@snac.com.au.
authors.forename: M H
authors.initials: MH
authors.lastname: Barnett
mesh_terms: D006801:Humans; D059906:Neuroimaging / Q000379:methods / Q000639:trends; D009471:Neuromyelitis Optica / Q000175:diagnosis