The radiological spectrum of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is defined by distinct MRI features that reflect its unique pathophysiology. Key imaging findings, including large, ovoid, and ADEM-like lesions, extensive optic nerve involvement, and longitudinally extensive transverse myelitis (LETM), play a crucial role in differentiating MOGAD from other demyelinating disorders such as multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). Additionally, the presence of significant contrast enhancement and characteristic gray matter involvement further supports accurate diagnosis.[1,2,7].

Recognizing these imaging characteristics is essential in establishing a timely and precise diagnosis, as MOGAD can present with overlapping clinical features seen in other central nervous system demyelinating conditions. [1]. The ability to correlate radiological patterns with clinical presentations ensures appropriate disease classification and guides therapeutic decision-making. Given the evolving understanding of MOGAD and its variable presentation, ongoing collaboration between radiologists and clinicians is critical for improving patient outcomes. As awareness of this condition continues to grow, further research and advancements in imaging techniques will enhance diagnostic accuracy and contribute to the optimization of individualized treatment strategies.