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Criteria improving multiple sclerosis diagnosis at the first MRI
Nathalie Caucheteux1, Adil Maarouf, Margaux Genevray
1Service de Neurologie, CHU Reims, Hôpital Maison Blanche, 45 rue Cognacq Jay, 51092, Reims Cedex, France.
Journal of Neurology
|February 17, 2015
Summary
New criteria enable earlier multiple sclerosis (MS) diagnosis using a single MRI. This method identifies MS in 99.3% of patients, significantly faster than current McDonald criteria.
Area of Science:
- Neurology
- Radiology
- Immunology
Background:
- The McDonald criteria facilitate early multiple sclerosis (MS) diagnosis.
- However, the 2010 criteria still leave nearly 50% of patients with "possible MS" after initial MRI.
- A need exists for faster diagnostic methods post-first MRI.
Purpose of the Study:
- To demonstrate earlier MS diagnosis using a single MRI with proposed criteria.
- To evaluate the association of symptomatic and suggestive lesions for diagnosis.
- To assess the short-term predictive capacity of suggestive lesions on disease activity.
Main Methods:
- Retrospective analysis of initial MRI scans from 146 MS patients.
- Utilized symptomatic lesions as primary criterion.
- Incorporated suggestive lesion (SL) characteristics or positive CSF as secondary criteria.
Main Results:
- Proposed criteria achieved 100% sensitivity, diagnosing 99.3% of patients (145/146) from the first MRI.
- 143 patients (97.9%) had at least one SL; 3 had positive CSF.
- Diagnosis time was significantly shorter than the 2010 McDonald criteria.
Conclusions:
- The proposed criteria offer high sensitivity and enable earlier MS diagnosis than the 2010 McDonald criteria.
- Specific lesion patterns (corpus callosum, temporal horn, ovoid) predict future disease activity.
- Prospective studies are recommended to confirm specificity and findings.
