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多发性硬化症的过度诊断与磁共振成像标准

Overdiagnosis of multiple sclerosis and magnetic resonance imaging criteria.

作者信息

Nielsen Jessica M, Korteweg Tijmen, Barkhof Frederik, Uitdehaag Bernard M J, Polman Chris H

机构信息

Department of Neurology, VU University Medical Centre, Amsterdam, Netherlands.

出版信息

Ann Neurol. 2005 Nov;58(5):781-3. doi: 10.1002/ana.20632.

Abstract

Retrospectively, we assessed the specificity of two proposed magnetic resonance imaging (MRI) criteria for multiple sclerosis (MS) in patients suspected to have MS but who ultimately receive another diagnosis. Brain MRIs of 28 patients mixed with 28 MRIs of MS patients from the same cohort of 377 consecutively referred patients were scored by a neuroradiologist masked to the final diagnosis. The criteria for dissemination in space incorporated in the McDonald International Panel showed good specificity (89%). However, the more sensitive criteria proposed by a Subcommittee of the American Academy of Neurology resulted in a lower specificity (29%), indicating an increased risk of a false-positive diagnosis.

摘要

我们回顾性地评估了两种针对疑似患有多发性硬化症(MS)但最终确诊为其他疾病的患者所提出的磁共振成像(MRI)标准的特异性。由一位对最终诊断不知情的神经放射科医生,对来自同一队列的377例连续转诊患者中28例混合了28例MS患者MRI的脑MRI进行评分。纳入麦克唐纳国际小组的空间播散标准显示出良好的特异性(89%)。然而,美国神经病学学会一个小组委员会提出的更敏感的标准导致特异性较低(29%),这表明假阳性诊断风险增加。

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