Application of the 2010 McDonald criteria for the diagnosis of multiple sclerosis in a Spanish cohort of patients with clinically isolated syndromes

2011 ◽  
Vol 18 (1) ◽  
pp. 39-44 ◽  
Author(s):  
M Gómez-Moreno ◽  
M Díaz-Sánchez ◽  
A Ramos-González
Keyword(s):  
Multiple Sclerosis ◽  
Mri Scan ◽  
Clinically Isolated Syndromes ◽  
Mcdonald Criteria ◽  
International Panel ◽  
Clinical Onset ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity ◽  
New Criteria

Background: Recently the International Panel on Diagnosis of Multiple Sclerosis (MS) has proposed new magnetic resonance imaging (MRI) criteria for the diagnosis of MS in patients with clinically isolated syndromes (CIS). We aimed to evaluate the accuracy of these new criteria for lesions dissemination in space (DIS) and time (DIT), from a single MRI scan, to predict conversion from CIS to clinically definite MS. Methods: We studied 67 CIS patients with baseline MRI performed within the first 3 months after onset. The follow-up was of at least 24 months. The sensitivity, specificity and accuracy of Barkhof–Tintoré criteria and the new proposed MRI criteria for DIS and DIT were calculated with SPSS v.15.0. Results: The mean age for clinical onset was 30 years and 64% of patients were female. The overall conversion rate was 74%. In our cohort, Barkhof–Tintoré criteria showed a sensitivity of 71.43%, a specificity of 66.67%, with an accuracy of 73.1%. New DIS criteria showed a sensitivity of 85.71%, a specificity of 64.71% and an accuracy of 80.30%. We also evaluated the new DIT criteria with a single MRI scan in 54 patients with baseline scans that included gadolinium-enhanced images. The sensitivity of the test was 52.63% with a specificity of 75.00% and an accuracy of 59.26%. Conclusion: New DIS criteria are simpler and more sensitive than previous criteria. The sensitivity of DIT criterion using a single MRI scan was rather low, as other previous studies showed, reflecting its stringency, but it could improve the accuracy of early MS diagnosis in that group of patients with typical CIS and gadolinium-enhancing and non-enhancing lesions on their baseline scans. These results reinforce their use in MS diagnosis.

Multiple sclerosis diagnostic criteria: three years later

2005 ◽  
Vol 11 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Chris H Polman ◽  
Jerry S Wolinsky ◽  
Stephen C Reingold
Keyword(s):  
Multiple Sclerosis ◽  
Diagnostic Criteria ◽  
Wide Distribution ◽  
Mcdonald Criteria ◽  
International Panel ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity ◽  
Work Up ◽  
New Criteria ◽  
Prospective Analyses

New diagnostic criteria for multiple sclerosis (MS) were developed by an International Panel in 2001 and have had wide distribution and discussion since publication. These provided the first formal incorporation of magnetic resonance imaging (MRI) in a diagnosis work-up for patients suspected of having MS. The so-called McDonald criteria have been studied in retrospective and prospective analyses for sensitivity, specificity and utility, and have been proven to compare favourably or to be an improvement upon prior MS diagnostic criteria. The purpose of the current review is to present and evaluate the key studies that have been performed using the McDonald criteria since 2001 and to set the stage for an upcoming re-evaluation of the new criteria based on data-driven information gathered since their development.

Application and a proposed modification of the 2010 McDonald criteria for the diagnosis of multiple sclerosis in a Canadian cohort of patients with clinically isolated syndromes

2013 ◽  
Vol 20 (4) ◽  
pp. 458-463 ◽  
Author(s):  
H Kang ◽  
LM Metz ◽  
AL Traboulsee ◽  
M Eliasziw ◽  
GJ Zhao ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Resonance Imaging ◽  
Mri Scan ◽  
Randomized Controlled ◽  
Clinically Isolated Syndromes ◽  
Mcdonald Criteria ◽  
Magnetic Resonance Imaging Mri ◽  
Proposed Modification ◽  
The Impact

Background: The 2005 and 2010 McDonald criteria utilize magnetic resonance imaging (MRI) to provide evidence of disease dissemination in space (DIS) and time (DIT) for the diagnosis of multiple sclerosis (MS) in patients who have clinically isolated syndromes (CIS). Methods: Data from 109 CIS patients not satisfying the 2005 criteria at entry into a randomized controlled minocycline trial were analyzed to determine the proportion who would have been diagnosed with MS at screening based on 2010 criteria. The impact of including symptomatic, as well as asymptomatic, MRI lesions to confirm DIT was also explored. Results: Thirty percent (33/109) of patients, retrospectively, met the 2010 criteria for a diagnosis of MS at baseline. When both symptomatic and asymptomatic lesions were used to confirm DIT, three additional patients met the 2010 criteria. There was a significant 10.1% increase in the proportion of patients who met the 2010 DIS criteria, compared with the 2005 DIS criteria; however, two patients satisfied the 2005 DIS but not 2010 DIS criteria. Conclusion: Using 2010 McDonald criteria, 30% of the CIS patients could be diagnosed with MS using a single MRI scan. Inclusion of symptomatic lesions in the DIT criteria further increases this proportion to 33%.

Application of the McDonald 2010 criteria for the diagnosis of multiple sclerosis in an Argentinean cohort of patients with clinically isolated syndromes

2013 ◽  
Vol 19 (10) ◽  
pp. 1297-1301 ◽  
Author(s):  
L Patrucco ◽  
JI Rojas ◽  
JS Miguez ◽  
E Cristiano
Keyword(s):  
Multiple Sclerosis ◽  
Diagnostic Criteria ◽  
Latin American ◽  
Predictive Value ◽  
Genetic Population ◽  
International Panel ◽  
High Level ◽  
Sensitivity Specificity ◽  
New Criteria

Background: The International Panel on Diagnosis of Multiple Sclerosis has proposed new magnetic resonance imaging (MRI) criteria for the diagnosis of multiple sclerosis (MS) in patients with clinically isolated syndrome (CIS). We aimed to evaluate these new criteria in a cohort of patients from Buenos Aires, Argentina. Methods: Patients with CIS, in whom MRI was performed within three months of onset of symptoms, were included between January 2005–June 2010. Poser or McDonald 2005 criteria were used as gold standard diagnostic criteria for MS. MRI was assessed by a blind evaluator identifying recently diagnostic MS criteria. New criteria sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were determined. Results: Altogether 101 patients were included. Of these, 86 patients converted to MS (McDonald 2005/Poser) during the follow-up. The mean follow-up time was 7.3±3.2 years (range 1.8–11 years). Sensitivity was 84%, specificity 80%, PPV 96%, NPV 46% and accuracy 82%. The sub-analysis applied only to non-European descendants (mestizos, natives and zambos) showed a high level of accuracy for these new diagnostic criteria in this local ethnic/genetic population (sensitivity 77%, specificity 72%, PPV 94%, NPV 38%). Conclusions: This study assessing McDonald 2010 criteria in a Latin-American population may contribute to its international validation.

Revised McDonald criteria for multiple sclerosis diagnostics in Central Russia: Sensitivity and specificity

2014 ◽  
Vol 20 (14) ◽  
pp. 1896-1899 ◽  
Author(s):  
AN Belova ◽  
IV Shalenkov ◽  
DN Shakurova ◽  
AN Boyko
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Predictive Value ◽  
Russian Population ◽  
Mcdonald Criteria ◽  
International Panel ◽  
Central Russia ◽  
Sensitivity Specificity ◽  
Brain And Spinal Cord

Background: The 2010 revised McDonald criteria were developed with data gathered from Caucasian European and North American populations, and their applicability has been questioned for the Russian population. Objective: The objective of this report is to compare the specificity, accuracy, sensitivity and predictive value of MRI criteria incorporated to the new (2010) and old (2005) McDonald criteria for early multiple sclerosis (MS) diagnostics in the Nyzhnyi Novgorod (Russia) population. Methods: A total of 103 patients with symptoms suggestive of MS were recruited from 2008 to 2011 retrospectively. Patients were followed up until MS was confirmed or other proved diagnoses were determined. Their baseline and follow-up brain and spinal cord MRIs were retrospectively evaluated. Sixty-two patients (60%) converted to MS during the follow-up period (mean in 11±4.2 months). Results: In 41 cases (38%) diagnoses another than MS were established. The sensitivity, specificity, accuracy, PPV and NPV of the revised MRI criteria were 74%, 93%, 82%, 94%, 70%, respectively. Conclusions: Despite the limitations of our study, we conclude that the ability of the revised MRI criteria for early MS diagnostics in the Russian population is approximately similar to that determined by the international panel in Europe.

Paediatric multiple sclerosis: examining utility of the McDonald 2010 criteria

2011 ◽  
Vol 18 (5) ◽  
pp. 679-682 ◽  
Author(s):  
S Sedani ◽  
MJ Lim ◽  
C Hemingway ◽  
E Wassmer ◽  
M Absoud
Keyword(s):  
Multiple Sclerosis ◽  
Study Group ◽  
Resonance Imaging ◽  
Gadolinium Contrast ◽  
Mri Scan ◽  
Mcdonald Criteria ◽  
Paediatric Multiple Sclerosis ◽  
Magnetic Resonance Imaging Mri ◽  
Multiple Sclerosis Study Group

The new McDonald 2010 criteria have been recommended in paediatric multiple sclerosis (PMS). We aimed to assess the utility of McDonald 2010 criteria in comparison with 2007 International Paediatric Multiple Sclerosis Study Group (IPMSSG)-recommended criteria for PMS diagnosis. Retrospective analysis of 38 PMS cases from three UK demyelination clinics was conducted. Dissemination in space (DIS) and time (DIT) for both McDonald and IPMSSG criteria were noted on initial and follow-up magnetic resonance imaging (MRI). At first MRI scan, IPMSSG DIS criteria were fulfilled in 68% of scans and McDonald DIS criteria in 84%. In total, 11/18 children given gadolinium contrast fulfilled both McDonald DIS and DIT criteria on initial scan. The 2010 McDonald criteria appear more sensitive than IPMSSG and may allow PMS diagnosis at first presentation of CIS in at least a half of cases.

scholarly journals Diagnostic value of DWI-MRI for the detection of acute plaques in the relapse phase of multiple sclerosis

2021 ◽  
Vol 20 (1) ◽  
pp. 35-40
Author(s):  
Mehran Yousefi ◽  
◽  
Mehdi Panahali ◽  
Kamran Azarkhish ◽  
Nazanin Azizi Shalbaf ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Predictive Value ◽  
Brain Mri ◽  
Diagnostic Value ◽  
Gadolinium Contrast ◽  
Mcdonald Criteria ◽  
Contrast Enhanced ◽  
Gadolinium Contrast Agents ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Background. The 2010 revision of the McDonald criteria, widely used for the diagnosis of multiple sclerosis (MS), has established that dissemination in time (DIT) can be demonstrated by the simultaneous presence of asymptomatic gadolinium-enhancing and non-enhancing plaques on a single magnetic resonance imaging (MRI). When the use of gadolinium contrast agents is contraindicated, diffusion-weighted imaging (DWI) is utilized to confirm diffusion alterations in active inflammatory plaques. This study intended to examine whether DWI can be a viable alternative to contrast-enhanced T1-weighted imaging for demonstrating DIT in MS. Material and methods.We assessed 30 previously diagnosed MS patients during acute relapse (based on the 2010 McDonald criteria) and evaluated their brain MRI via DWI‚ contrast-enhanced T1-weighted imaging, and FLAIR sequences. Asymptomatic plaques were defined as either hyperintense or non-hyperintense in DWI and enhancing or non-enhancing in T1GAD-MRI. Statistical indices for the prediction of plaque enhancement in T1 GAD-MRI via DWI-MRI were calculated and compared. Results. The 30 participants in our study had a total of 925 demyelinating plaques that were larger than 3mm in size and presented to be hyperintense in FLAIR-MRI. Diffusion hyperintensity and plaque enhancement were significantly correlated. The sensitivity‚ specificity, positive predictive value‚ negative predictive value, and accuracy of DWI were calculated to be 69.66%‚ 99.76%‚ 96.88%‚ 96.86%, and 96.86%, respectively. Conclusions. Hyperintense DWI findings do not necessarily overlap with contrast enhancements in T1 GAD-MRI. DWI was shown to produce a higher rate of false-positive results. Our study concludes that although T1 GAD-MRI should not be replaced by DWI to determine DIT due to its lower specificity, DWI’s continued use as a surrogate screening imaging sequence whenever the use of T1GAD-MRI is of concern is not without its merits.

Pediatric onset multiple sclerosis: McDonald criteria 2010 and the contribution of spinal cord MRI

2013 ◽  
Vol 19 (10) ◽  
pp. 1330-1335 ◽  
Author(s):  
Hannah-Maria Hummel ◽  
Wolfgang Brück ◽  
Steffi Dreha-Kulaczewski ◽  
Jutta Gärtner ◽  
Jens Wuerfel
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Age At Onset ◽  
Regional Distribution ◽  
Pediatric Multiple Sclerosis ◽  
Mcdonald Criteria ◽  
Spinal Mri ◽  
Magnetic Resonance Imaging Mri ◽  
Pediatric Onset

Background: Diagnostic magnetic resonance imaging (MRI) criteria have not been sufficiently validated in pediatric multiple sclerosis (MS) despite differences in epidemiologic data and clinical disease courses between pediatric and adult MS. Objective: The objective of this paper is to evaluate the diagnostic applicability and validity of the revised McDonald diagnostic criteria 2010 in a large cohort of pediatric-onset MS patients (POMS) and compare them to previously recommended MRI-based classifications. Furthermore, we aimed to investigate the contribution of spinal cord lesions to the revised McDonald criteria 2010. Methods: A cohort of 85 patients with definite MS, age at onset 2.8–18 years, was analyzed in a retrospective multicenter study. Number and regional distribution of T2w and contrast-enhancing T1w lesions at initial and follow-up MRIs were main outcome measures. Results: In 62% of POMS the initial MRI within four weeks after symptom onset was sufficient to diagnose MS according to the revised McDonald criteria 2010. In a subcohort of patients with spinal MRI at first presentation, 10% reached the dissemination in space (DIS) and dissemination in time (DIT) criteria only by the inclusion of contrast-enhancing spinal lesions. Conclusions: The revised McDonald criteria 2010 facilitate the diagnosis of POMS already at first presentation. The addition of a spinal cord MRI was helpful only in selected cases.

Retrospective comparison of the original and revised McDonald criteria in a general neurology practice in Ireland

2008 ◽  
Vol 14 (1) ◽  
pp. 81-85 ◽  
Author(s):  
J.C. McHugh ◽  
P.L. Galvin ◽  
R.P. Murphy
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Diagnosis ◽  
Accurate Diagnosis ◽  
General Neurology ◽  
Clinical Notes ◽  
Clinically Isolated Syndromes ◽  
Mcdonald Criteria ◽  
Retrospective Comparison

Background The McDonald criteria were introduced in 2001 as guidelines to facilitate early and accurate diagnosis of multiple sclerosis (MS). They were revised in 2005. Although validated in a number of research-focused clinical centres, their adequacy and utility in the general neurology setting is less certain. Objective In this study, we assessed new diagnoses of MS in our practice for compliance with both the original and the revised criteria. Methods We retrospectively identified new diagnoses of MS from 2001. Clinical notes and imaging were evaluated for compliance with McDonald criteria. Results Sixty-two patients were included: 53 with `practice-definite' and nine with `practice-possible' diagnoses of MS. At the time of diagnosis, 47% of the `practice-definite' group fulfilled the 2001 criteria and 49% the revised criteria. Among patients not satisfying the criteria at time of diagnosis, 21% went on to fulfil the McDonald criteria over the 23-month follow-up. Conclusions There is a considerable gap between the clinical diagnosis of MS in a general neurology setting and compliance with the McDonald criteria. Failure to perform follow-up MRI on patients with clinically isolated syndromes is a sizeable factor in this diagnostic-gap and needs to be improved. In this setting, practical differences between the original and revised criteria appear to be small.

Clinical and diagnostic aspects of multiple sclerosis and acute monophasic encephalomyelitis in pediatric patients: a single centre prospective study

2009 ◽  
Vol 15 (3) ◽  
pp. 363-370 ◽  
Author(s):  
M Atzori ◽  
PA Battistella ◽  
P Perini ◽  
M Calabrese ◽  
M Fontanin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Prospective Study ◽  
Pediatric Patients ◽  
Age At Onset ◽  
Acute Disseminated Encephalomyelitis ◽  
First Episode ◽  
Laboratory Findings ◽  
Clinical Onset ◽  
Magnetic Resonance Imaging Mri

Objective The purpose of the study was to compare and contrast the initial presenting demographic, clinical, neuroimaging, and laboratory features in a cohort of children affected from multiple sclerosis (MS) or acute disseminated encephalomyelitis (ADEM). Methods A 12-year prospective study was conducted in 68 pediatric patients (age ≤ 17 years) who presented with a first episode of central nervous system inflammation suggestive of a demyelinating multifocal pathology. All patients had undergone magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) examination. The mean follow-up period, as at ending on December 31, 2007, was 6.8 ± 2.7 years (range 3.2–12.6 years). Results At clinical onset, children who developed MS during the follow-up (48 patients; 34 females, 14 males; mean age at onset: 14.4 ± 2.5) significantly differed from children affected by ADEM (20 patients; 8 females, 12 males; mean age at onset: 8.1 ± 3.8 ) for the following parameters: prevalence of females affected (female/male ratio: 2.8 versus 0.6, P = 0.03); mean age at onset ( P < 0.001); monosymptomatic onset (73% vs 30%, P = 0.002); encephalopathy-like onset (0% vs 50%, P < 0.001); presence of oligoclonal IgG bands (IgGOB) in CSF (83% vs 10%, P < 0.001); and periventricular (79% vs 20%, P < 0.001), brain stem (12.5% vs 60%, P = 0.000), and basal ganglia (10% vs 50%, P < 0.001) lesions at MRI. Conclusions Our findings depict a pattern of demographic, clinical, neuroimaging, and laboratory findings that can help to distinguish, at clinical onset, children suffering from ADEM from those who will develop MS. Childhood-onset MS seems not to differ from adult-onset MS from both clinical and paraclinical features.

Evaluation of 2016 MAGNIMS MRI criteria for dissemination in space in patients with a clinically isolated syndrome

2017 ◽  
Vol 24 (6) ◽  
pp. 758-766 ◽  
Author(s):  
Jae-Won Hyun ◽  
So-Young Huh ◽  
Woojun Kim ◽  
Min Su Park ◽  
Suk-Won Ahn ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Clinically Isolated Syndrome ◽  
Clinical Event ◽  
Resonance Imaging ◽  
Predictive Values ◽  
Mcdonald Criteria ◽  
Sensitivity Specificity

Objectives: We compared validity of 2010 McDonald and newly proposed 2016 Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) criteria for dissemination in space (DIS) in predicting the conversion to clinically definite multiple sclerosis (CDMS) in patients with clinically isolated syndrome (CIS). Methods: Between 2006 and 2016, we enrolled 170 patients who had a first clinical event suggestive of multiple sclerosis (MS) from seven referral hospitals in Korea. Patients were classified into two groups based on the main outcome at the last follow-up: CDMS converters, who experienced a second attack, and non-converters. Results: Of 170 patients with mean follow-up duration of 54 months, 51% converted to CDMS. The sensitivity, specificity, accuracy, and positive and negative predictive values of 2010 McDonald criteria were 70.9%, 63.1%, 67.1%, 66.3%, and 67.9%, and those for 2016 MAGNIMS criteria were 88.4%, 46.4%, 67.7%, 62.8%, and 79.6%, respectively. When we excluded 80 patients who underwent disease-modifying therapy before the second clinical event, the specificity increased to 92.3% and 84.6%, but the sensitivity decreased to 58.8% and 82.4% for 2010 McDonald and 2016 MAGNIMS criteria, respectively. Conclusion: 2016 MAGNIMS magnetic resonance imaging (MRI) criteria for DIS showed higher sensitivity but lower specificity than 2010 McDonald criteria in predicting conversion to CDMS in CIS patients.

Sign in / Sign up

Export Citation Format

Share Document