Department of Radiology, University of British Columbia (UBC), Canada.
Mult Scler. 2014 Apr;20(4):458-63. doi: 10.1177/1352458513501230. Epub 2013 Aug 22.
The 2005 and 2010 McDonald criteria utilize magnetic resonance imaging (MRI) to provide evidence of disease dissemination in space (DIS) and time (DIT) for the diagnosis of multiple sclerosis (MS) in patients who have clinically isolated syndromes (CIS).
Data from 109 CIS patients not satisfying the 2005 criteria at entry into a randomized controlled minocycline trial were analyzed to determine the proportion who would have been diagnosed with MS at screening based on 2010 criteria. The impact of including symptomatic, as well as asymptomatic, MRI lesions to confirm DIT was also explored.
Thirty percent (33/109) of patients, retrospectively, met the 2010 criteria for a diagnosis of MS at baseline. When both symptomatic and asymptomatic lesions were used to confirm DIT, three additional patients met the 2010 criteria. There was a significant 10.1% increase in the proportion of patients who met the 2010 DIS criteria, compared with the 2005 DIS criteria; however, two patients satisfied the 2005 DIS but not 2010 DIS criteria.
Using 2010 McDonald criteria, 30% of the CIS patients could be diagnosed with MS using a single MRI scan. Inclusion of symptomatic lesions in the DIT criteria further increases this proportion to 33%.
2005 年和 2010 年 McDonald 标准利用磁共振成像（MRI）为临床上孤立综合征（CIS）患者的多发性硬化症（MS）诊断提供疾病在空间（DIS）和时间（DIT）上的扩散证据。
对未满足 2005 年标准的 109 例 CIS 患者进入随机对照米诺环素试验的数据进行分析，以确定根据 2010 年标准在筛查时被诊断为 MS 的患者比例。还探讨了包括症状性和无症状性 MRI 病变以确认 DIT 的影响。
30%（33/109）的患者回顾性地在基线时符合 2010 年 MS 诊断标准。当使用症状性和无症状性病变来确认 DIT 时，另外有 3 名患者符合 2010 年标准。与 2005 年 DIS 标准相比，符合 2010 年 DIS 标准的患者比例显著增加了 10.1%；然而，有 2 名患者符合 2005 年 DIS 标准但不符合 2010 年 DIS 标准。
使用 2010 年 McDonald 标准，单次 MRI 扫描可诊断 30%的 CIS 患者患有 MS。将症状性病变纳入 DIT 标准可将这一比例进一步提高到 33%。
