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Longitudinally extensive transverse myelitis is NMO\u2019s imaging hallmark and the presence of a brain MRI that is not diagnostic of multiple sclerosis (MS) also remains part of the diagnostic criteria. It is increasingly recognised that MS and NMO brain imaging can, however, have similar appearances but differences do exist: hypothalamic, periaqueductal grey and area postrema lesions implicate NMO whilst cortical, U-fibre or Dawson\u2019s finger lesions are suggestive of MS. The timing of image acquisition, age, ethnicity and aquaporin-4 antibody status are all likely to alter the findings at MRI. This review therefore aims to overview and update the reader on NMO imaging, to provide clinically relevant guidance for diagnosing NMO and differentiating it from MS in order to guide management, and to highlight recent research insights.<\/jats:p>","DOI":"10.1177\/1352458514531087","type":"journal-article","created":{"date-parts":[[2014,5,14]],"date-time":"2014-05-14T22:59:25Z","timestamp":1400108365000},"page":"1153-1164","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":49,"title":["Magnetic resonance imaging in neuromyelitis optica"],"prefix":"10.1177","volume":"20","author":[{"given":"George","family":"Tackley","sequence":"first","affiliation":[{"name":"Oxford University Hospitals Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilhelm","family":"Kuker","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals Trust, 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