Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis
Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis
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DOI：
10.1093/brain/120.11.2059
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发表时间：
1997-11-01
期刊：
影响因子：
14.5
通讯作者：
Valk, J
中科院分区：
文献类型：
--
作者：
Barkhof, F;Filippi, M;Valk, J
我们比较了用于预测疑似多发性硬化症转化为临床明确多发性硬化症的MRI标准。本文对74例临床孤立的多发性硬化症神经系统症状的患者进行了MRI研究。采用Logistic回归分析剔除冗余信息，利用受者工作特征分析对各MRI参数进行最大准确率二分类，建立诊断模型。临床明确多发性硬化症33例（患病率45%）。对于大多数MRI标准（包括钆增强和皮质旁病变），最佳分界点（病变数量）为1，但对于心室周围病变为3，对于t- 2病变总数为9。只有钆增强和皮质旁病变提供了独立的信息。最后一个模型，除了包括幕下和脑室周围病变外，准确率为80%，并且有更多的异常标准，强烈地预测了临床明确的多发性硬化症的转变。该模型的表现优于party等人（Neurology 1988; 38: 180-5）和Fazekas等人（Neurology 1988; 38: 1822-5）的标准。我们的结论是，包括钆增强、皮质旁、幕下和脑室周围病变在内的四参数二分化MRI模型最能预测临床明确的多发性硬化症的转变。
We compared MRI criteria used to predict conversion of suspected multiple sclerosis to clinically definite multiple sclerosis. Seventy-four patients with clinically isolated neurological symptoms suggestive of multiple sclerosis were studied with MRI. Logistic regression analysis was used to remove redundant information, and a diagnostic model was built after each MRI parameter was dichotomized according to maximum accuracy using receiver operating characteristic analysis. Clinically definite multiple sclerosis developed in 33 patients (prevalence 45%). The optimum cut-off point (number of lesions) was one for most MRI criteria (including gadolinium-enhancement and juxtacortical lesions), but three for periventricular lesions, and nine for the total number of T-2-lesions. Only gadolinium-enhancement and juxta-cortical lesions provided independent information. A final model which, in addition, included infratentorial and periventricular lesions, had an accuracy of 80%, and having more abnormal criteria, predicted conversion to clinically definite multiple sclerosis strongly. The model performed better than the criteria of Paty et al. (Neurology 1988; 38: 180-5) and of Fazekas et al. (Neurology 1988; 38: 1822-5). We concluded that a four-parameter dichotomized MRI model including gadolinium-enhancement, juxtacortical, infratentorial and periventricular lesions best predicts conversion to clinically definite multiple sclerosis.