ABSTRACT
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.
Subject(s)
Brain/pathology , Multiple Sclerosis/diagnosis , Spinal Cord/pathology , Adult , Cohort Studies , Early Diagnosis , Female , Humans , Magnetic Resonance Imaging , Male , Predictive Value of Tests , Retrospective Studies , Russia , Sensitivity and Specificity , Young AdultSubject(s)
Brain/pathology , Neurosyphilis/complications , Paralysis/etiology , Anti-Bacterial Agents/therapeutic use , Disease Progression , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Middle Aged , Neurosyphilis/diagnosis , Neurosyphilis/drug therapy , Paralysis/diagnosis , Severity of Illness IndexABSTRACT
Revised 2010 McDonald criteria for multiple sclerosis (MS) give possibility for early diagnosis using magnetic resonance imaging (MRI) and, in some cases, allow to establish a confirmed diagnosis of MS even after the first referral that is very important for timely diagnosis. However the new criteria should be tested in different samples of patients. The aim of our work was to evaluate the ability to use the new McDonald criteria in the Nyzhegorodsky population. Clinical and neuroimaging features of 103 patients with signs and symptoms proposed for MS were retrospectively analyzed according to the revised McDonald criteria. Sensitivity, specificity, accuracy, positive and negative predictive values for conversion from clinically isolated syndromes to clinically definite multiple sclerosis were calculated. The results of the study were similar to those approved by the international panel for European populations. It has been concluded that the early diagnosis of MS can be established on the basis of a single MRI but the use of these criteria is limited by the high price of MRI.
