Journal ArticleDOI
MRI in the diagnosis of MS A prospective study with comparison of clinical evaluation, evoked potentials, oligoclonal banding, and CT
Donald W. Paty,Joel Oger,Lorne F. Kastrukoff,S. A. Hashimoto,John P. Hooge,Andrew Eisen,K. A. Eisen,S. J. Purves,M. D. Low,V. Brandejs,W. D. Robertson,David Kb Li +11 more
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TLDR
MRI was the best method for demonstrating dissemination in space and laboratory-supported definite MS (LSDMS) could be diagnosed in 85 patients of the total 200, and MRI predicted that diagnosis in 18/19 (95%).Abstract:
We compared the diagnostic capabilities of MRI to CT, evoked potentials (EP), and CSF oligoclonal banding analysis in a prospective evaluation of 200 patients with suspected multiple sclerosis (MS). MRI was the best method for demonstrating dissemination in space. An abnormal appropriate EP in monosymptomatic disease was usually supported by MRI and CSF anaylsis as being predictive of MS as a clinical diagnosis. A normal appropriate EP study was not satisfactory because MRI and CSF analysis often did not support a diagnosis of non-MS . When there is agreement between three of these paraclinical studies, the diagnosis of MS is probably unequivocal. For use in research studies, laboratory-supported definite MS (LSDMS) could be diagnosed in 85 patients of the total 200 (42.5%), in 19/38 (50%) of optic neuritis (ON) patients, and in 24/52 (46%) of chronic progressive myelopathy (CPM) patients. MRI was 100% successful in identifying patients who qualified for LSDMS in the ON and CPM groups. In a short follow-up (less than 1 year), 19/200 (10%) went on to develop clinically definite MS (CDMS), and MRI predicted that diagnosis in 18/19 (95%). Only long-term follow-up will show how well these studies and the category of LSDMS predict the development of CDMS. The clinical diagnosis of MS (CDMS), even though only 95% accurate, must remain the gold standard.read more
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Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria
Chris H. Polman,Stephen C. Reingold,Brenda Banwell,Michel Clanet,Jeffrey A. Cohen,Massimo Filippi,Kazuo Fujihara,Eva Havrdova,Michael Hutchinson,Ludwig Kappos,Fred D. Lublin,Xavier Montalban,Paul L. O’Connor,Magnhild Sandberg-Wollheim,Alan J. Thompson,Emmanuelle Waubant,Brian G. Weinshenker,Jerry S. Wolinsky +17 more
TL;DR: These revisions simplify the McDonald Criteria, preserve their diagnostic sensitivity and specificity, address their applicability across populations, and may allow earlier diagnosis and more uniform and widespread use.
Journal ArticleDOI
Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the Diagnosis of Multiple Sclerosis
W. Ian McDonald,A Compston,Gilles Edan,Donald E. Goodkin,Hans-Peter Hartung,Fred D. Lublin,Henry F. McFarland,Donald W. Paty,Chris H. Polman,Stephen C. Reingold,Magnhild Sandberg-Wollheim,William A. Sibley,Alan J. Thompson,Stanley van den Noort,Brian Y. Weinshenker,Jerry S. Wolinsky +15 more
TL;DR: The revised criteria facilitate the diagnosis of MS in patients with a variety of presentations, including “monosymptomatic” disease suggestive of MS, disease with a typical relapsing‐remitting course, and disease with insidious progression, without clear attacks and remissions.
Journal ArticleDOI
Revised diagnostic criteria for neuromyelitis optica
TL;DR: Revised diagnostic criteria for definite neuromyelitis optica (NMO) that require optic neuritis, myelitis, and at least two of three supportive criteria: MRI evidence of a contiguous spinal cord lesion 3 or more segments in length, onset brain MRI nondiagnostic for multiple sclerosis, or NMO-IgG seropositivity.
Journal ArticleDOI
The clinical course of neuromyelitis optica (Devic's syndrome)
TL;DR: Clinical, laboratory, and imaging features generally distinguish neuromyelitis optica from MS, and patients with relapsing optic neuritis and myelitis may have neuromyeliitis opticas rather than MS.
Journal ArticleDOI
Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis.
Frederik Barkhof,Massimo Filippi,David Miller,Philip Scheltens,Adriana Campi,Chris H. Polman,Giancarlo Comi,Herman J. Adèr,N. A. Losseff,Jacob Valk +9 more
TL;DR: It is concluded that a four-parameter dichotomized MRI model including gadolinium-enhancement, juxtacortical, infratentorial and periventricular lesions best predicts conversion to clinically definite multiple sclerosis.
References
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New diagnostic criteria for multiple sclerosis: guidelines for research protocols.
Charles M. Poser,Donald W. Paty,Labe C. Scheinberg,W I McDonald,F A Davis,George C. Ebers,Kenneth P. Johnson,William A. Sibley,Donald H. Silberberg,Wallace W. Tourtellotte +9 more
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Journal ArticleDOI
The initial diagnosis of multiple sclerosis: Clinical impact of magnetic resonance imaging
TL;DR: MRI, in this limited series, proved to be a strong tool in the initial diagnosis of multiple sclerosis; it may prove to be the single best test, with a sensitivity exceeding that of electrodiagnostic studies and cerebrospinal fluid analysis.
Journal ArticleDOI
Correlation between nmr scan and brain slice data in multiple sclerosis
Journal ArticleDOI
Nuclear magnetic resonance imaging of multiple sclerosis
TL;DR: Ten patients with definite multiple sclerosis underwent hydrogen nuclear magnetic resonance imaging with a 3.5 kilogauss superconducting magnet, using the inversion recovery and spin-echo techniques of signal acquisition, and each demonstrated more extensive abnormalities than did computed tomography.