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多发性硬化症的误诊:过去、现在和未来。

Misdiagnosis of Multiple Sclerosis: Past, Present, and Future.

机构信息

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Department of Neurological Sciences, Larner College of Medicine, The University of Vermont, 1 South Prospect St., Burlington, VT, 05477, USA.

出版信息

Curr Neurol Neurosci Rep. 2024 Nov;24(11):547-557. doi: 10.1007/s11910-024-01371-w. Epub 2024 Sep 7.

Abstract

PURPOSE OF REVIEW

Misdiagnosis of multiple sclerosis (MS) is a prevalent worldwide problem. This review discusses how MS misdiagnosis has evolved over time and focuses on contemporary challenges and potential strategies for its prevention.

RECENT FINDINGS

Recent studies report cohorts with a range of misdiagnosis between 5 and 18%. Common disorders are frequently misdiagnosed as MS. Overreliance on MRI findings and misapplication of MS diagnostic criteria are often associated with misdiagnosis. Emerging imaging biomarkers, including the central vein sign and paramagnetic rim lesions, may aid diagnostic accuracy when evaluating patients for suspected MS. MS misdiagnosis can have harmful consequences for patients and healthcare systems. Further research is needed to better understand its causes. Concerted and novel educational efforts to ensure accurate and widespread implementation of MS diagnostic criteria remain an unmet need. The incorporation of diagnostic biomarkers highly specific for MS in the future may prevent misdiagnosis.

摘要

目的综述

多发性硬化症(MS)的误诊是一个普遍存在的全球性问题。本综述讨论了 MS 误诊是如何随时间演变的,并重点介绍了当代的挑战和潜在的预防策略。

最近的发现

最近的研究报告了误诊率在 5%至 18%之间的队列。常见疾病常被误诊为 MS。过度依赖 MRI 结果和错误应用 MS 诊断标准常与误诊有关。新兴的影像学生物标志物,包括中央静脉征和顺磁性边缘病变,在评估疑似 MS 患者时可能有助于提高诊断准确性。MS 误诊对患者和医疗保健系统都可能产生有害后果。需要进一步研究以更好地了解其原因。为确保 MS 诊断标准的准确和广泛实施,需要做出协调一致的新努力。在未来,具有 MS 高度特异性的诊断生物标志物的应用可能会防止误诊。

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