Neuromyelitis optica spectrum disorder CT
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Julinka Auta Fernandes
Overview
Computed tomography (CT) is not included as a diagnostic imaging criterion for neuromyelitis optica spectrum disorder (NMOSD) in the cited recommendations. The recommended neurological imaging assessment uses magnetic resonance imaging (MRI) of the brain and spinal cord.[1][2]
Key CT Findings in Neuromyelitis Optica Spectrum Disorder
Brain, Orbital, and Spinal CT
Neuromyelitis optica spectrum disorder has no characteristic diagnostic CT pattern defined in the cited diagnostic recommendations.[1][2]
- Diagnostic limitations: A normal CT scan does not exclude NMOSD. CT does not fulfil the MRI requirements specified in the diagnostic criteria.[1][2]
- Optic neuritis: The 2026 consensus statement developed under the Indian Neuro-Ophthalmology Society (INOS) does not recommend CT for diagnosing optic neuritis. This is general optic neuritis guidance relevant to the evaluation of an optic nerve presentation of NMOSD.[3]
Chest CT for Differential Diagnosis
In suspected neuromyelitis optica spectrum disorder, chest CT may help investigate sarcoidosis when neurosarcoidosis is a possible alternative diagnosis.[1][4]
- When to consider chest CT: The British Thoracic Society (BTS) statement supports thin-section chest CT when suspected sarcoidosis presents with atypical chest radiographic findings, disagreement between clinical and radiographic findings, or diagnostic uncertainty.[4]
- Potential findings: Thoracic sarcoidosis may show symmetric hilar and mediastinal lymphadenopathy, small pulmonary nodules distributed along lymphatic routes, and fibrosis with distortion of lung architecture.[4]
- Interpretation: These findings support further assessment for thoracic sarcoidosis. CT may help guide selection of a site for tissue sampling when this is required.[4]
Image credit: James Heilman, MD, Wikimedia Commons. Licensed under Creative Commons Attribution–ShareAlike 4.0.[5]
References
- ↑ 1.0 1.1 1.2 1.3 Jarius S, Aktas O, Ayzenberg I, et al. (2023). "Update on the diagnosis and treatment of neuromyelits optica spectrum disorders (NMOSD) – revised recommendations of the Neuromyelitis Optica Study Group (NEMOS). Part I: Diagnosis and differential diagnosis". Journal of Neurology. 270 (7): 3341–3368. doi:10.1007/s00415-023-11634-0. PMC 10267280 Check
|pmc=value (help). PMID 37022481 Check|pmid=value (help). - ↑ 2.0 2.1 2.2 Yamout B, Gouider R, Al-Roughani R, et al. (2026). "Consensus Recommendations for the Diagnosis and Treatment of Neuromyelitis Optica Spectrum Disorders (NMOSD): The MENACTRIMS Guidelines". CNS Drugs. 40 (3): 283–303. doi:10.1007/s40263-025-01260-x. PMID 41591715 Check
|pmid=value (help). - ↑ Phuljhele S, Saxena R, Bhatia R, et al. (2026). "Consensus statement for the diagnosis and management of optic neuritis". Indian Journal of Ophthalmology. 74 (8): 1115–1121. doi:10.4103/IJO.IJO_1634_26. PMC 13485077 Check
|pmc=value (help). PMID 42535805 Check|pmid=value (help). - ↑ 4.0 4.1 4.2 4.3 Thillai M, Atkins CP, Crawshaw A, et al. (2021). "BTS Clinical Statement on pulmonary sarcoidosis". Thorax. 76 (1): 4–20. doi:10.1136/thoraxjnl-2019-214348. PMID 33268456 Check
|pmid=value (help). - ↑ Heilman, James (2016-05-28). "File:HilarAdenopathyCT.png". Wikimedia Commons. Retrieved 2026-10-29. External link in
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