Tas M W, Barkhol F, van Walderveen M A, Polman C H, Hommes O R, Valk J
Department of Diagnostic Radiology, Free University Hospital, Amsterdam, The Netherlands.
AJNR Am J Neuroradiol. 1995 Feb;16(2):259-64.
To determine whether gadolinium can improve the sensitivity and specificity of MR imaging for the initial diagnosis of multiple sclerosis.
Patients (n = 57) with neurologic symptoms suggesting multiple sclerosis were studied prospectively. MR imaging consisted of T2-weighted and gadolinium-enhanced T1-weighted spin-echo images. Lumbar puncture was performed for cerebrospinal fluid analysis in 34 patients.
After imaging, 17 patients (35%) had clinically definite multiple sclerosis. Cerebrospinal fluid examination had a sensitivity of 69% and specificity of 38%. Using liberal criteria, the sensitivity of T2-weighted MR imaging was 94% and the specificity 55%; using more strict criteria, the specificity increased to 65% with a sensitivity of 88%. Gadopentetate dimeglumine enhancement increased the specificity further to 80% with a loss of sensitivity (59%).
Gadolinium enhancement increases the specificity of MR imaging in the early diagnosis of multiple sclerosis.
确定钆是否能提高磁共振成像（MRI）对多发性硬化症初始诊断的敏感性和特异性。
对57例有提示多发性硬化症神经症状的患者进行前瞻性研究。MRI检查包括T2加权和钆增强T1加权自旋回波图像。34例患者进行了腰椎穿刺以分析脑脊液。
成像后，17例患者（35%）患有临床确诊的多发性硬化症。脑脊液检查的敏感性为69%，特异性为38%。采用宽松标准时，T2加权MRI的敏感性为94%，特异性为55%；采用更严格标准时，特异性增至65%，敏感性为88%。钆喷酸葡胺增强进一步将特异性提高到80%，但敏感性有所下降（59%）。
钆增强可提高MRI在多发性硬化症早期诊断中的特异性。
