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调查及时传播是否对于诊断复发性多发性硬化症至关重要

Wallace J Brownlee^1,2, Michael A Foster¹, Giuseppe Pontillo^1,3

¹Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Institute of Neurology, London, United Kingdom.

|March 4, 2025

概括

诊断多发性硬化症 (MS) 可能并不总是需要时间传播 (DIT) 证据,如果空间传播 (DIS) 标准得到充分满足. 在特定区域的高DIS损伤数量可以准确诊断MS,可能简化诊断过程.

科学领域:

神经学神经学
神经免疫学神经免疫学
放射学放射学是一门学科.

背景情况:

多发性硬化症 (MS) 诊断需要证明在空间 (DIS) 和时间 (DIT) 的传播.
大脑脊髓液 (CSF) 的基克隆带 (OCB) 可以替代MRI定义的DIT.
当DIS标准得到严格满足时,DIT或OCB的必要性正在调查中.

研究的目的:

评估DIT或CSF分析是否对于患有广泛DIS病变的患者的MS诊断至关重要.
在一个潜在的队列中评估不同DIS标准的诊断性能.
建议为成员国提供简化诊断算法.

主要方法:

预期招募经历第一个脱髓化事件的患者.
在发病后3个月内进行脑脊髓MRI,并进行临床和MRI随访.
对2017年麦当劳标准 (DIS + DIT或OCBs) 进行DIS标准 (包括视神经在内的2-4/4或2-5/5区域的损伤) 的追溯应用.

主要成果:

在244名患者中,187名 (77%) 在11.2年内被诊断患有MS.
在≥4/4区域的DIS显示了MS诊断的高特异性 (100%).
在≥4/5区域 (包括视神经) 的DIS也表现出高特异性 (100%).

结论:

在≥4个区域的空间传播 (DIS) 对MS诊断具有高度特异性.
满足广泛的DIS标准可能会减少对后续MRI或CSF分析的需求.
这一发现可以简化疑似MS的诊断途径.

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