Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is an immune-mediated demyelinating disease that is challenging to differentiate from multiple sclerosis (MS), as the clinical phenotypes overlap, and people with MOGAD can fulfil the current MRI-based diagnostic criteria for MS. In addition, the MOG antibody assays that are an essential component of MOGAD diagnosis are not standardized. Accurate diagnosis of MOGAD is crucial because the treatments and long-term prognosis differ from those for MS. This Expert Recommendation summarizes the outcomes from a Magnetic Resonance Imaging in MS workshop held in Oxford, UK in May 2022, in which MS and MOGAD experts reflected on the pathology and clinical features of these disorders, the contributions of MRI to their diagnosis and the clinical use of the MOG antibody assay. We also critically reviewed the literature to assess the validity of distinctive imaging features in the current MS and MOGAD criteria. We conclude that dedicated orbital and spinal cord imaging (with axial slices) can inform MOGAD diagnosis and also illuminate differential diagnoses. We provide practical guidance to neurologists and neuroradiologists on how to navigate the current MOGAD and MS criteria. We suggest a strategy that includes useful imaging discriminators on standard clinical MRI and discuss imaging features detected by non-conventional MRI sequences that demonstrate promise in differentiating these two disorders.

髓鞘少突胶质细胞糖蛋白 （MOG） 抗体相关疾病 （MOGAD） 是一种免疫介导的脱髓鞘疾病，由于临床表型重叠，因此难以与多发性硬化症 （MS） 区分开来，并且 MOGAD 患者可以满足当前基于 MRI 的 MS 诊断标准。此外，作为 MOGAD 诊断的重要组成部分的 MOG 抗体检测尚未标准化。MOGAD 的准确诊断至关重要，因为 MOGAD 的治疗和长期预后与 MS 不同。本专家建议总结了 2022 年 5 月在英国牛津举行的 MS 磁共振成像研讨会的结果，在该研讨会上，MS 和 MOGAD 专家反思了这些疾病的病理学和临床特征、MRI 对诊断的贡献以及 MOG 抗体测定的临床应用。我们还批判性地回顾了文献，以评估当前 MS 和 MOGAD 标准中独特成像特征的有效性。我们得出结论，专用的眼眶和脊髓成像（使用轴向切片）可以为 MOGAD 诊断提供信息，也可以阐明鉴别诊断。我们为神经科医生和神经放射科医生提供有关如何浏览当前 MOGAD 和 MS 标准的实用指导。我们提出了一种策略，包括标准临床 MRI 上有用的影像学鉴别器，并讨论了非常规 MRI 序列检测到的影像学特征，这些特征在区分这两种疾病方面显示出前景。