Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland/School of Medicine & Medical Science, University College Dublin, Dublin, Ireland.
Mult Scler. 2019 May;25(6):867-870. doi: 10.1177/1352458518770088. Epub 2018 Apr 12.
The International Panel on Diagnosis of Multiple Sclerosis (MS) recently revised the 2010 McDonald criteria and made recommendations for revision, allowing for the earliest possible, accurate diagnosis of MS. For relapsing-remitting MS, positive, unmatched cerebrospinal fluid oligoclonal bands may substitute for dissemination in time. Symptomatic lesions, including brainstem and spinal cord, may demonstrate dissemination in space or in time if enhancing (with the exception of the optic nerve). Cortical and juxtacortical lesions are equivalent. In this retrospective analysis, we applied revised criteria to 250 patients previously diagnosed with relapsing-remitting MS according to 2010 criteria and assessed for change in diagnostic times. There was a significant improvement in time to diagnosis between 2010 and 2017 groups ( p < 0.01). Median time to diagnosis according to McDonald 2010 was 7.4 months, compared with 2.3 months for McDonald 2017. Use of cerebrospinal fluid results most frequently resulted in a reduction in time to diagnosis. Symptomatic gadolinium-enhancing lesions led to earliest diagnostic times.
国际多发性硬化症诊断小组（MS）最近修订了 2010 年麦当劳标准，并提出了修订建议，以便尽早、准确地诊断多发性硬化症。对于复发缓解型多发性硬化症，阳性、不匹配的脑脊液寡克隆带可替代时间上的传播。如果增强（视神经除外），包括脑干和脊髓在内的症状性病变可能在空间或时间上显示出传播。皮质和皮质下病变是等同的。在这项回顾性分析中，我们根据 2010 年的标准对 250 例以前诊断为复发缓解型多发性硬化症的患者应用了修订后的标准，并评估了诊断时间的变化。与 2010 年组相比，2017 年组的诊断时间有显著改善（p<0.01）。根据麦当劳 2010 年的标准，中位数诊断时间为 7.4 个月，而根据麦当劳 2017 年的标准为 2.3 个月。脑脊液结果的使用最常导致诊断时间的缩短。症状性钆增强病变导致最早的诊断时间。
