Magnetic resonance imaging in immune-mediated myelopathies

  • M. J. Wendebourg
  • S. Nagy
  • T. Derfuss
  • K. Parmar
  • R. SchlaegerEmail author


Immune-mediated myelopathies are a heterogeneous group of inflammatory spinal cord disorders including autoimmune disorders with known antibodies, e.g. aquaporin-4 IgG channelopathy or anti-myelin oligodendrocyte glycoprotein-associated myelitis, myelopathies in the context of multiple sclerosis and systemic autoimmune disorders with myelopathy, as well as post-infectious and paraneoplastic myelopathies. Although magnetic resonance imaging of the spinal cord is still challenging due to the small dimension of the cord cross-section and frequent movement and susceptibility artifacts, recent methodological advances have led to improved diagnostic evaluation and characterization of immune-mediated myelopathies. Topography, length and width of the lesion, gadolinium enhancement pattern, and changes in morphology over time help in narrowing the broad differential diagnosis. In this review, we give an overview of recent advances in magnetic resonance imaging of immune-mediated myelopathies and its role in the differential diagnosis and monitoring of this heterogeneous group of disorders.


Immune-mediated myelopathies Autoimmune myelopathies Myelitis Magnetic resonance imaging Multiple sclerosis NMOSD 



We thank Dorothee Heinrich for her help and expertise in the graphic representation of different myelopathy lesions and Dr. Matthias Weigel and Prof. Oliver Bieri, Division of Radiological Physics, Department of Radiology, University Hospital Basel, and Department of Biomedical Engineering, University of Basel, Basel, CH for contributing the SC AMIRA image.

Compliance with ethical standards

Conflicts of interest

The authors declare no conflict of interest.

Ethical considerations/informed consent

Written consent for the use of MR images was obtained from all patients prior to the inclusion in our review.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • M. J. Wendebourg
    • 1
  • S. Nagy
    • 1
    • 2
  • T. Derfuss
    • 3
  • K. Parmar
    • 1
  • R. Schlaeger
    • 1
    Email author
  1. 1.Neurology Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital BaselUniversity of BaselBaselSwitzerland
  2. 2.University Children’s Hospital of Basel, University of BaselBaselSwitzerland
  3. 3.Neurology Clinic and Policlinic, Departments of Medicine and BiomedicineUniversity Hospital Basel and University of BaselBaselSwitzerland

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