Application of the McDonald MRI criteria in multiple sclerosis
Annals of the Academy of Medicine, Singapore
; : 647-654, 2007.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-250789
Biblioteca responsável:
WPRO
ABSTRACT
<p><b>INTRODUCTION</b>The aim of this study was to assess the sensitivity of McDonald's magnetic resonance imaging (MRI) criteria for the diagnosis of multiple sclerosis (MS) in a group of Asian patients diagnosed with clinically definite MS, based on lesion characterisation on MRI scans.</p><p><b>MATERIALS AND METHODS</b>Forty-nine patients from 3 major neurological institutions were classified as having Asian- or Western-type MS based on clinical assessment. Each MRI scan was reviewed by 2 neuroradiologists for the presence and characteristics of brain and spinal lesions. The McDonald's MRI criteria were then applied and its sensitivity evaluated.</p><p><b>RESULTS</b>Nine patients were excluded, leaving 34 females and 6 males who were dominantly Chinese (90%), with a mean age of 36.2 years. The MRI brain and spinal findings were detailed and tabulated. Statistically significant differences (P <0.01) in MRI brain findings and sensitivity of McDonald's MRI criteria were found between our Asian- and Western-type MS patients. The diagnostic yield of McDonald's MRI criteria increased by 20% when we substituted a cord for a brain lesion, and applied the substitution for enhancing cord lesions as well.</p><p><b>CONCLUSION</b>The diagnosis is more likely to be made when using McDonald MRI criteria based on brain findings, in a patient who presents clinically with Western-type MS. The provision for substitution of "one brain for a spinal lesion" is helpful in Asian-type MS, where there is preponderance of spinal lesion load. Our findings suggest that minor modifications in the interpretation of McDonald's MRI criteria have significant impact on the diagnosis in patients clinically presenting as Asian-type MS, with potential bearing on their subsequent management.</p>
Texto completo:
Disponível
Contexto em Saúde:
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Doenças Imunológicas
/
Esclerose Multipla
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Patologia
/
Singapura
/
Traumatismos da Medula Espinal
/
Lesões Encefálicas
/
Imageamento por Ressonância Magnética
/
Estudos Retrospectivos
/
Sensibilidade e Especificidade
/
Classificação
/
Diagnóstico
/
Diagnóstico Diferencial
Tipo de estudo:
Estudo diagnóstico
/
Estudo observacional
Limite:
Adulto
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
Annals of the Academy of Medicine, Singapore
Ano de publicação:
2007
Tipo de documento:
Artigo