临床孤立综合征患者多发性硬化症MRI诊断标准的改良

• 作 者: Swanton J.K Fernando K Dalton C.M D.H. Miller 郭俊
• 机 构: NMR Research Unit Institute of Neurology Queen Square London WC1N 3BG United Kingdom Prof. ,
• 出 处: 世界核心医学期刊文摘(神经病学分册)
• 发表日期: 2006年11期
• 关键词: 多发性硬化症 诊断标准 综合征 空间分布 时间分布 基线 队列 敏感性 准确性 敏感度

Background: The McDonald criteria include MRI evidence for dissemination in space and dissemination in time for the diagnosis of multiple sclerosis in young adult patients who present with clinically isolated syndromes (CIS) typical of the disease. Although a major advance, the criteria have limited sensitivity for making an early diagnosis. Objective: To compare the performance of McDonald criteria and modified McDonald criteria for dissemination in space and time for assessing the development of clinically definite multiple sclerosis. Methods: McDonald criteria were modified using the combination of a less stringent definition for dissemination in space and allowing a new T2 lesion per se after three months as evidence for dissemination in time. Modified and McDonald criteria were applied in 90 CIS patients at baseline and at three month follow up scans. Results: Both criteria were highly specific ( > 90%)but the modified criteria were more sensitive (77%v 46%) and more accurate (86%v 73%). Conclusions: These modified criteria should be evaluated in other CIS cohorts.

Background: The McDonald criteria include MRI evidence for dissemination in space and dissemination in time for the diagnosis of multiple sclerosis in young adult patients who present with clinically isolated syndromes (CIS) typical of the disease. Although a major advance, the criteria have limited sensitivity for making an early diagnosis. Objective: To compare the performance of McDonald criteria and modified McDonald criteria for dissemination in space and time for assessing the development of clinically definite multiple sclerosis. Methods: McDonald criteria were modified using the combination of a less stringent definition for dissemination in space and allowing a new T2 lesion per se after three months as evidence for dissemination in time. Modified and McDonald criteria were applied in 90 CIS patients at baseline and at three month follow up scans. Results: Both criteria were highly specific (> 90%) but the modified criteria were more sensitive (77% v 46%) and more accurate (86% v 73%). Conclusions: These modified criteria should be evaluated in other CIS cohorts.