Specificity of Barkhof criteria in predicting conversion to multiple sclerosis when applied to clinically isolated brainstem syndromes
Specificity of Barkhof criteria in predicting conversion to multiple sclerosis when applied to clinically isolated brainstem syndromes
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DOI：
10.1001/archneur.61.2.222
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发表时间：
2004-02-01
影响因子：
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通讯作者：
Montalban, X
中科院分区：
文献类型：
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作者：
Sastre-Garriga, J;Tintoré, M;Montalban, X
背景资料：在新的多发性硬化诊断标准中，Barkhof标准已被用于证明空间传播，因为它们对预测多发性硬化的转化具有高度特异性。4个Barkhof标准之一是存在幕下病变。在脑干临床孤立综合征（CIS）中，幕下标准并不显示空间播散，这增加了该标准在CISB中特异性较低的可能性，而在其他CIS中，所有4个标准都显示空间播散。目的：比较Barkhof标准在CISB中与其他CIS中的有效性指数。设计：初始队列与中位随访时间为34个月的CISB和40个月的其他CIS.Setting：机构门诊转诊center.Patients：样本51例CISB和102例其他CIS（46与myeloma和56与视神经炎）进行了分析。Barkhof标准，截止值为3/4，应用于基线时进行的磁共振成像。四个组合，每个包含3个参数也被应用，截止值为2的3。主要结果测量：特异性的未修改的Barkhof标准和4个组合，以预测转换为临床确诊的多发性sclerosis.Results：特异性的标准在CISB是61%对73%，在其他CIS。保留幕下病变参数的组合有较低的特异性在CISB组，在与其他CIS组的分析，没有这样的差异被发现。结论：幕下病变标准是负责较低的特异性Barkhof标准CISB。
Background: Barkhof criteria have been adopted to demonstrate dissemination in space in the new multiple sclerosis diagnostic criteria because of their high specificity for predicting conversion to multiple sclerosis. One of the 4 Barkhof criteria is the presence of an infratentorial lesion. In clinically isolated syndromes (CIS) of the brainstem (CISB), the infratentorial criterion does not demonstrate dissemination in space, raising the possibility that the criteria may be less specific in CISB, as compared with specificity in other CIS, in which all 4 criteria demonstrate dissemination in space.Objective: To compare the validity indices of Barkhof criteria in CISB with those in other CIS.Design: Inception cohort with median follow-up of 34 months for CISB and 40 months for other CIS.Setting: Institutional ambulatory referral center.Patients: A sample of 51 patients with CISB and 102 patients with other CIS (46 with myelitis and 56 with optic neuritis) was analyzed. Barkhof criteria, with a cutoff of 3 of 4, were applied to magnetic resonance imaging performed at baseline. Four combinations each containing 3 parameters were also applied, with a cutoff of 2 of 3.Main Outcome Measure: Specificity of unmodified Barkhof criteria and of the 4 combinations to predict conversion to clinically definite multiple sclerosis.Results: The specificity of the criteria in CISB was 61% against 73% in other CIS. The combinations that retained the infratentorial lesion parameter had lower specificities in the CISB group; in analysis of the group with other CIS, no such differences were found.Conclusion: The infratentorial lesion criterion is responsible for the lower specificity of Barkhof criteria in CISB.