Short term validity of Barkhof and Swanton magnetic resonance imaging criteria for multiple sclerosis in patients with clinically isolated syndromes

Background: Magnetic resonance imaging (MRI) evidence for dissemination in space (DIS) and dissemination in time (DIT) is used within the McDonald criteria for the diagnosis of multiple sclerosis. In order to make an earlier diagnosis of clinically definite multiple sclerosis (CDMS) in patients with...

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Bibliographic Details
Published in:Multiple sclerosis 2008-09, Vol.14, p.S113-S113
Main Authors: Miralles, FCP, Bosca, I, Magraner, MJ, Pascual, A M, Bosca, ME, Coret, F, Casanova, B
Format: Article
Language:English
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Summary:Background: Magnetic resonance imaging (MRI) evidence for dissemination in space (DIS) and dissemination in time (DIT) is used within the McDonald criteria for the diagnosis of multiple sclerosis. In order to make an earlier diagnosis of clinically definite multiple sclerosis (CDMS) in patients with clinically isolated syndromes (CIS), new criteria were proposed in which DIS requires at least one T2 lesion in at least two of four locations (juxtacortical, periventricular, infra-tentorial and spinal cord), and DIT requires a new T2 lesion on a follow-up MRI. Objective: To compare Barkhof criteria and the new proposed MRI criteria (Swanton) by use of conversion to CDMS. Methods: The former and latter MRI criteria were applied in a cohort of 49 patients with CIS, both at baseline and at least three months follow up MRI. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of both MRI criteria for the presence of a second relapse after one year of follow-up was performed. Results: The sensitivity of the new criteria was 86.66% (95% CI 59 - 98%), and of Barkhof criteria 80% (95% CI 51 - 95%). The specificity of the new criteria was 44.11% (95% CI 27 - 62%), meanwhile Barkhof criteria was 55.88 (95% CI 29 - 67%). The PPV was almost the same for both criteria (40.62% for the new criteria and 44.44% for Barkhof criteria). The NPV was slightly higher in the new criteria (88.23% vs 86.36%). The accuracy of the new criteria was 57.4% (95% CI 43.3 - 71%), and of Barkhof criteria 63.26% (95% CI 49.76 - 76.75%). Conclusions: The new MRI criteria for DIS and DIT are simpler than the former ones, and they are at least as reliable as Barkhof criteria. There are no significant differences between criteria in sensitivity and specificity, after one year of follow-up.
ISSN:1352-4585