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俄罗斯中部修订后的多发性硬化症诊断麦当劳标准:敏感性和特异性。

Revised McDonald criteria for multiple sclerosis diagnostics in central Russia: sensitivity and specificity.

机构信息

Regional Multiple Sclerosis Center, Nizhniy Novgorod, Russia.

Pirogov's Russian Scientific Research Medical University and Moscow MS Center, Russian State Medical University, Neurology, Russia

出版信息

Mult Scler. 2014 Dec;20(14):1896-9. doi: 10.1177/1352458514539405. Epub 2014 Aug 21.

Abstract

BACKGROUND

The 2010 revised McDonald criteria were developed with data gathered from Caucasian European and North American populations, and their applicability has been questioned for the Russian population.

OBJECTIVE

The objective of this report is to compare the specificity, accuracy, sensitivity and predictive value of MRI criteria incorporated to the new (2010) and old (2005) McDonald criteria for early multiple sclerosis (MS) diagnostics in the Nyzhnyi Novgorod (Russia) population.

METHODS

A total of 103 patients with symptoms suggestive of MS were recruited from 2008 to 2011 retrospectively. Patients were followed up until MS was confirmed or other proved diagnoses were determined. Their baseline and follow-up brain and spinal cord MRIs were retrospectively evaluated. Sixty-two patients (60%) converted to MS during the follow-up period (mean in 11±4.2 months).

RESULTS

In 41 cases (38%) diagnoses another than MS were established. The sensitivity, specificity, accuracy, PPV and NPV of the revised MRI criteria were 74%, 93%, 82%, 94%, 70%, respectively.

CONCLUSIONS

Despite the limitations of our study, we conclude that the ability of the revised MRI criteria for early MS diagnostics in the Russian population is approximately similar to that determined by the international panel in Europe.

摘要

背景

2010 年修订的 McDonald 标准是基于白种欧洲人和北美人的数据制定的,其在俄罗斯人群中的适用性受到了质疑。

目的

本报告的目的是比较新(2010 年)和旧(2005 年) McDonald 标准中纳入的 MRI 标准在俄罗斯尼热诺戈尔斯克(俄罗斯)人群中早期多发性硬化症(MS)诊断的特异性、准确性、敏感性和预测值。

方法

我们回顾性地招募了 2008 年至 2011 年期间出现 MS 症状的 103 名患者。对患者进行随访,直到确诊为 MS 或确定其他明确诊断。回顾性评估他们的基线和随访脑和脊髓 MRI。在随访期间,62 名患者(60%)转化为 MS(平均时间为 11±4.2 个月)。

结果

在 41 例(38%)诊断为 MS 以外的其他疾病。修订后的 MRI 标准的敏感性、特异性、准确性、PPV 和 NPV 分别为 74%、93%、82%、94%、70%。

结论

尽管我们的研究存在局限性,但我们得出结论,修订后的 MRI 标准在俄罗斯人群中进行早期 MS 诊断的能力与欧洲国际专家组确定的能力大致相似。

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