Brain, Vol 120, Issue 11 2059-2069, Copyright © 1997 by Oxford University Press
F Barkhof, M Filippi, DH Miller, P Scheltens, A Campi, CH Polman, G Comi, HJ Ader, N Losseff and J Valk
We compared MRI criteria used to predict conversion of suspected multiple
sclerosis to clinically definite multiple sclerosis. Seventy- four patients
with clinically isolated neurological symptoms suggestive of multiple
sclerosis were studied with MRI. Logistic regression analysis was used to
remove redundant information, and a diagnostic model was built after each
MRI parameter was dichotomized according to maximum accuracy using receiver
operating characteristic analysis. Clinically definite multiple sclerosis
developed in 33 patients (prevalence 45%). The optimum cut-off point
(number of lesions) was one for most MRI criteria (including
gadolinium-enhancement and juxta- cortical lesions), but three for
periventricular lesions, and nine for the total number of T2-lesions. Only
gadolinium-enhancement and juxta- cortical lesions provided independent
information. A final model which, in addition, included infratentorial and
periventricular lesions, had an accuracy of 80%, and having more abnormal
criteria, predicted conversion to clinically definite multiple sclerosis
strongly. The model performed better than the criteria of Paty et al.
(Neurology 1988; 38: 180-5) and of Fazekas et al. (Neurology 1988; 38:
1822-5). We concluded that a four-parameter dichotomized MRI model
including gadolinium-enhancement, juxtacortical, infratentorial and
periventricular lesions best predicts conversion to clinically definite
multiple sclerosis.
REVIEWS
Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis
Department of Diagnostic Radiology, Vrije Universiteit Hospital, Amsterdam, The Netherlands.
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