title: The effect of gadolinium on the sensitivity and specificity of MR in the initial diagnosis of multiple sclerosis.
abstract: OBJECTIVE
  To determine whether gadolinium can improve the sensitivity and specificity of MR imaging for the initial diagnosis of multiple sclerosis.
  
  
  METHODS
  Patients (n = 57) with neurologic symptoms suggesting multiple sclerosis were studied prospectively. MR imaging consisted of T2-weighted and gadolinium-enhanced T1-weighted spin-echo images. Lumbar puncture was performed for cerebrospinal fluid analysis in 34 patients.
  
  
  RESULTS
  After imaging, 17 patients (35%) had clinically definite multiple sclerosis. Cerebrospinal fluid examination had a sensitivity of 69% and specificity of 38%. Using liberal criteria, the sensitivity of T2-weighted MR imaging was 94% and the specificity 55%; using more strict criteria, the specificity increased to 65% with a sensitivity of 88%. Gadopentetate dimeglumine enhancement increased the specificity further to 80% with a loss of sensitivity (59%).
  
  
  CONCLUSIONS
  Gadolinium enhancement increases the specificity of MR imaging in the early diagnosis of multiple sclerosis.
authors.affiliation: Department of Diagnostic Radiology, Free University Hospital, Amsterdam, The Netherlands.
authors.forename: M W
authors.initials: MW
authors.lastname: Tas
authors.forename: F
authors.initials: F
authors.lastname: Barkhol
authors.forename: M A
authors.initials: MA
authors.lastname: van Walderveen
authors.forename: C H
authors.initials: CH
authors.lastname: Polman
authors.forename: O R
authors.initials: OR
authors.lastname: Hommes
authors.forename: J
authors.initials: J
authors.lastname: Valk
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D003287:Contrast Media; D004338:Drug Combinations; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis*; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D019786:Gadolinium DTPA