评估 2016 年 MAGNIMS MRI 标准在临床孤立综合征患者中的空间传播。
Evaluation of 2016 MAGNIMS MRI criteria for dissemination in space in patients with a clinically isolated syndrome.
机构信息
Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Korea.
Department of Neurology, College of Medicine, Kosin University, Busan, Korea.
出版信息
Mult Scler. 2018 May;24(6):758-766. doi: 10.1177/1352458517706744. Epub 2017 May 11.
OBJECTIVES
We compared validity of 2010 McDonald and newly proposed 2016 Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) criteria for dissemination in space (DIS) in predicting the conversion to clinically definite multiple sclerosis (CDMS) in patients with clinically isolated syndrome (CIS).
METHODS
Between 2006 and 2016, we enrolled 170 patients who had a first clinical event suggestive of multiple sclerosis (MS) from seven referral hospitals in Korea. Patients were classified into two groups based on the main outcome at the last follow-up: CDMS converters, who experienced a second attack, and non-converters.
RESULTS
Of 170 patients with mean follow-up duration of 54 months, 51% converted to CDMS. The sensitivity, specificity, accuracy, and positive and negative predictive values of 2010 McDonald criteria were 70.9%, 63.1%, 67.1%, 66.3%, and 67.9%, and those for 2016 MAGNIMS criteria were 88.4%, 46.4%, 67.7%, 62.8%, and 79.6%, respectively. When we excluded 80 patients who underwent disease-modifying therapy before the second clinical event, the specificity increased to 92.3% and 84.6%, but the sensitivity decreased to 58.8% and 82.4% for 2010 McDonald and 2016 MAGNIMS criteria, respectively.
CONCLUSION
2016 MAGNIMS magnetic resonance imaging (MRI) criteria for DIS showed higher sensitivity but lower specificity than 2010 McDonald criteria in predicting conversion to CDMS in CIS patients.
目的
我们比较了 2010 年 McDonald 标准和新提出的 2016 年多发性硬化症磁共振成像（MAGNIMS）空间弥散标准（DIS）在预测临床孤立综合征（CIS）患者向临床确诊多发性硬化症（CDMS）转化中的有效性。
方法
在 2006 年至 2016 年期间，我们纳入了来自韩国 7 家转诊医院的 170 名首次出现多发性硬化症（MS）临床症状的患者。根据最后一次随访的主要结局，将患者分为两组：发生第二次发作的 CDMS 转化者和未转化者。
结果
在 170 名患者中，中位随访时间为 54 个月，51%的患者转化为 CDMS。2010 年 McDonald 标准的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为 70.9%、63.1%、67.1%、66.3%和 67.9%，2016 年 MAGNIMS 标准的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为 88.4%、46.4%、67.7%、62.8%和 79.6%。当我们排除 80 名在第二次临床事件前接受疾病修正治疗的患者后，2010 年 McDonald 标准的特异性分别提高至 92.3%和 84.6%，但敏感性分别降至 58.8%和 82.4%，2016 年 MAGNIMS 标准的特异性分别提高至 88.4%和 84.6%，但敏感性分别降至 58.8%和 82.4%。
结论
在预测 CIS 患者向 CDMS 转化方面，2016 年 MAGNIMS MRI DIS 标准的敏感性高于 2010 年 McDonald 标准，但特异性较低。
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