title: Isolated demyelinating syndromes: comparison of different MR imaging criteria to predict conversion to clinically definite multiple sclerosis.
abstract: OBJECTIVE
  Various authors have developed criteria to classify MR imaging findings that suggest the possibility of multiple sclerosis. The purpose of this study was to evaluate and compare the capacity of three sets of MR imaging criteria for predicting the conversion of isolated demyelinating syndromes to clinically definite multiple sclerosis.
  
  
  METHODS
  Seventy patients with clinically isolated neurologic symptoms suggestive of multiple sclerosis were prospectively studied with MR imaging. The MR imaging findings were evaluated by two independent neuroradiologists who were blinded to clinical follow-up data. Based on the clinical outcome at follow-up (presence of a second attack that established clinically definite multiple sclerosis), the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the criteria proposed by Paty et al, Fazekas et al, and Barkhof et al were calculated.
  
  
  RESULTS
  Clinically definite multiple sclerosis developed in 22 (31%) patients after a mean follow-up time of 28.3 months. The criteria proposed by Paty et al and those proposed by Fazekas et al showed identical results: sensitivity, 86%; specificity, 54%; accuracy, 64%; positive predictive value, 46%; and negative predictive value, 89%. The criteria proposed by Barkhof et al showed the following: sensitivity, 73%; specificity, 73%; accuracy, 73%; positive predictive value, 55%; and negative predictive value, 85%.
  
  
  CONCLUSIONS
  The four dichotomized MR imaging parameters proposed by Barkhof et al are more specific and accurate than the criteria proposed by Paty et al or Fazekas et al for predicting conversion to clinically definite multiple sclerosis.
authors.affiliation: Department of Neurology, Vall d'Hebron University Hospitals, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Tintoré
authors.forename: A
authors.initials: A
authors.lastname: Rovira
authors.forename: M J
authors.initials: MJ
authors.lastname: Martínez
authors.forename: J
authors.initials: J
authors.lastname: Rio
authors.forename: P
authors.initials: P
authors.lastname: Díaz-Villoslada
authors.forename: L
authors.initials: L
authors.lastname: Brieva
authors.forename: C
authors.initials: C
authors.lastname: Borrás
authors.forename: E
authors.initials: E
authors.lastname: Grivé
authors.forename: J
authors.initials: J
authors.lastname: Capellades
authors.forename: X
authors.initials: X
authors.lastname: Montalban
mesh_terms: D000328:Adult; D003711:Demyelinating Diseases / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity