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A search for new MRI criteria for dissemination in space in subjects with a clinically isolated syndrome |
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| Authors: | T Korteweg M Tintore B M J Uitdehaag D L Knol H Vrenken A Rovira J Frederiksen D H Miller K Fernando M Filippi F Agosta M A Rocca F Fazekas C Enzinger A Parry C H Polman X Montalban F Barkhof |
| Institution: | 1. Department of Radiology, VU University Medical Centre, De Boelelaan 1118, 1081, HV, Amsterdam, The Netherlands 2. Department of Neuroimmunology, Hospital Vall d’Hebron, Barcelona, Spain 3. Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands 4. Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands 5. Department of Physics and Medical Technology, VU University Medical Centre, Amsterdam, The Netherlands 6. Department of Radiology, Magnetic Resonance Unit, Hospital Vall d’Hebron, Barcelona, Spain 7. The MS Clinic, Department of Neurology, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark 8. MS NMR Research Unit, Department of Neuroinflammation, Institute of Neurology, University College London, London, United Kingdom 9. Neuroimaging Research Unit, Department of Neurology, Scientific Institute and University Ospedale San Raffaele, Milan, Italy 10. Department of Neurology, Medical University Graz, Graz, Austria 11. Department of Clinical Neurology, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom |
| Abstract: | The International Panel on the Diagnosis of Multiple Sclerosis (MS) incorporated the Barkhof/Tintoré (B/T) magnetic resonance criteria into their diagnostic scheme to provide evidence of dissemination in space of central nervous system lesions, a prerequisite for diagnosing MS in patients who present with clinically isolated syndromes (CIS). Although specific for MS, the B/T criteria were criticised for their low sensitivity and relative complexity in clinical use. We used lesion characteristics at onset from 349 CIS patients in logistic regression and recursive partitioning modelling in a search for simpler and more sensitive criteria, while maintaining current specificity. The resulting models, all based on the presence of periventricular and deep white matter lesions, performed roughly in agreement with the B/T criteria, but were unable to provide higher diagnostic accuracy based on information from a single scan. Apparently, findings from contrast-enhanced and follow-up magnetic resonance scans are needed to improve the diagnostic algorithm. |
| Keywords: | Magnetic resonance imaging Multiple sclerosis Diagnosis |
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