Konen Franz Felix, Schwenkenbecher Philipp, Wattjes Mike P, Skripuletz Thomas
Klinik für Neurologie mit Klinischer Neurophysiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
Institut für Diagnostische und Interventionelle Neuroradiologie, Medizinische Hochschule Hannover, Hannover, Deutschland.
Nervenarzt. 2023 Jun;94(6):538-545. doi: 10.1007/s00115-022-01410-2. Epub 2022 Dec 1.
A rapid and reliable diagnosis of multiple sclerosis (MS) is crucial to initiate adapted disease-modifying treatment. The 2017 McDonald criteria were revised with the aim of further improving the diagnostic performance.
In this article the published studies comparing the use of the 2017 and 2010 McDonald criteria were reviewed and analyzed in terms of diagnostic performance.
A total of 20 studies and 1 review article with a total of 3006 evaluated patients were identified by means of a literature search in the PubMed database (search term: McDonald criteria 2010 and McDonald criteria 2017).
Using the 2017 McDonald criteria, a diagnosis of MS was made in more patients (2277/3006 patients, 76%) and in an earlier stage (3-10 months) compared with the 2010 revision (1562/3006 patients, 52%). Of the additional MS diagnoses, 193/715 were due to the adjustment of the imaging criteria of temporal dissemination and 536/715 were due to the introduction of oligoclonal bands as a diagnostic criterion.
The revised McDonald criteria of 2017 have achieved their goal and enable the diagnosis of MS in a higher proportion of patients at the first clinical event.
对多发性硬化症（MS）进行快速可靠的诊断对于启动适当的疾病修正治疗至关重要。2017年麦克唐纳标准进行了修订，旨在进一步提高诊断性能。
本文对已发表的比较2017年和2010年麦克唐纳标准使用情况的研究进行了回顾，并从诊断性能方面进行了分析。
通过在PubMed数据库中进行文献检索（检索词：2010年麦克唐纳标准和2017年麦克唐纳标准），共识别出20项研究和1篇综述文章，总计3006例接受评估的患者。
与2010年修订版相比，使用2017年麦克唐纳标准诊断出的MS患者更多（2277/3006例患者，76%），且诊断时间更早（3 - 10个月）（2010年修订版为1562/3006例患者，52%）。在新增的MS诊断中，193/715例是由于对时间播散成像标准的调整，536/715例是由于引入寡克隆带作为诊断标准。
2017年修订的麦克唐纳标准已实现其目标，能够在首次临床事件中对更高比例的患者诊断出MS。
