title: Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis.
abstract: 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 juxta-cortical lesions), but three for periventricular lesions, and nine for the total number of T2-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.
authors.affiliation: Department of Diagnostic Radiology, Vrije Universiteit Hospital, Amsterdam, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Barkhof
authors.forename: M
authors.initials: M
authors.lastname: Filippi
authors.forename: D H
authors.initials: DH
authors.lastname: Miller
authors.forename: P
authors.initials: P
authors.lastname: Scheltens
authors.forename: A
authors.initials: A
authors.lastname: Campi
authors.forename: C H
authors.initials: CH
authors.lastname: Polman
authors.forename: G
authors.initials: G
authors.lastname: Comi
authors.forename: H J
authors.initials: HJ
authors.lastname: Adèr
authors.forename: N
authors.initials: N
authors.lastname: Losseff
authors.forename: J
authors.initials: J
authors.lastname: Valk
mesh_terms: D005188:False Negative Reactions; D005189:False Positive Reactions; D005682:Gadolinium; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000175:diagnosis*; D011237:Predictive Value of Tests; D013997:Time Factors
chemical_list: D005682:Gadolinium