Department of Neurology, Medical University of Vienna, Austria.
Mult Scler. 2012 Dec;18(12):1768-74. doi: 10.1177/1352458512444661. Epub 2012 Apr 23.
Magnetic resonance imaging diagnostic criteria for paediatric multiple sclerosis have been established on the basis of brain imaging findings alone. The 2010 McDonald criteria for the diagnosis of multiple sclerosis, however, include spinal cord imaging for detection of lesion dissemination in space. The new criteria have been recommended in paediatric multiple sclerosis.
(1) To evaluate the 2010 McDonald multiple sclerosis criteria in children with a clinically isolated syndrome and to compare them with recently proposed magnetic resonance criteria for children; (2) to assess whether the inclusion of spinal cord imaging provided additional value to the 2010 McDonald criteria.
We performed a retrospective analysis of brain and spinal cord magnetic resonance imaging scans from 52 children with a clinically isolated syndrome. Sensitivity, specificity and accuracy of the magnetic resonance criteria were assessed.
The 2010 McDonald dissemination in space criteria were more sensitive (85% versus 74%) but less specific (80% versus 100%) compared to the 2005 McDonald criteria. The Callen criteria were more accurate (89%) compared to the 2010 McDonald (85%), the 2005 McDonald criteria for dissemination in space (81%), the KIDMUS criteria (46%) and the Canadian Pediatric Demyelinating Disease Network criteria (76%). The 2010 McDonald criteria for dissemination in time were more accurate (93%) than the dissemination in space criteria (85%). Inclusion of the spinal cord did not increase the accuracy of the McDonald criteria.
儿科多发性硬化症的磁共振成像诊断标准仅基于脑部影像学发现而建立。然而，2010 年多发性硬化症 McDonald 诊断标准包括脊髓成像，以检测空间病变扩散。新的标准已被推荐用于儿科多发性硬化症。
（1）评估 2010 年 McDonald 多发性硬化症标准在具有临床孤立综合征的儿童中的应用，并将其与最近提出的儿童磁共振标准进行比较；（2）评估脊髓成像的纳入是否为 2010 年 McDonald 标准提供了额外的价值。
我们对 52 例具有临床孤立综合征的儿童的脑部和脊髓磁共振成像扫描进行了回顾性分析。评估了磁共振标准的敏感性、特异性和准确性。
与 2005 年 McDonald 标准相比，2010 年 McDonald 标准在空间扩散中的标准更敏感（85%对 74%），但特异性较低（80%对 100%）。Callen 标准比 2010 年 McDonald（85%）、2005 年 McDonald 标准的空间扩散（81%）、KIDMUS 标准（46%）和加拿大儿科脱髓鞘疾病网络标准（76%）更准确。2010 年 McDonald 标准在时间上的扩散更准确（93%对 85%）。脊髓的纳入并未增加 McDonald 标准的准确性。
