Wiendl H, Kieseier B C, Gold R, Hohlfeld R, Bendszus M, Hartung H-P
Neurologische Klinik und Poliklinik, Julius-Maximilians-Universität, Würzburg.
Nervenarzt. 2006 Oct;77(10):1235, 1237-45. doi: 10.1007/s00115-006-2127-6.
In 2001, an international panel suggested new diagnostic criteria for multiple sclerosis (MS). These criteria integrate clinical, imaging (MRI), and paraclinical results in order to facilitate diagnosis. Since then, these so-called McDonald criteria have been broadly accepted and widely propagated. In the meantime a number of publications have dealt with the sensitivity and specificity for MS diagnosis and with implementing these new criteria in clinical practice. Based on these empirical values and newer data on MS, an international expert group recently proposed a revision of the criteria. Substantial changes affect (1) MRI criteria for the dissemination of lesions over time, (2) the role of spinal cord lesions in the MRI and (3) diagnosis of primary progressive MS. In this article we present recent experiences with the McDonald and revised criteria.
2001年,一个国际专家小组提出了多发性硬化症(MS)的新诊断标准。这些标准整合了临床、影像学(MRI)和辅助检查结果,以促进诊断。自那时起,这些所谓的麦克唐纳标准已被广泛接受并广泛传播。与此同时,许多出版物探讨了MS诊断的敏感性和特异性,以及在临床实践中实施这些新标准的情况。基于这些经验值和关于MS的最新数据,一个国际专家小组最近提议对标准进行修订。重大变化影响到:(1)病变随时间扩散的MRI标准;(2)脊髓病变在MRI中的作用;(3)原发进展型MS的诊断。在本文中,我们介绍了使用麦克唐纳标准和修订后标准的最新经验。