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We previously compared the diagnostic capabilities of MRI of the head with CT,evoked potentials,and CSF oligoclonal banding(OB)analysis in a prospective evaluation of 200 patients with suspected multiple sclerosis (MS).To examine the ability of MRI and other paraclinical tests to predict the diagnosis of clinically definite MS(CDMS),we did a systematic clinical follow-up of 200 patients who were previously reported.In that study,85 of 200 could be diagnosed as having laboratory-supported definite MS(LSDMS). In follow-up,we excluded one patient diagnosed as LSDMS who in retrospect was considered to have had CDMS at entry and 15 patients who were eventually diagnosed as having other diseases.After a mean follow-up of 2. 1 years,55 of the remaining 1884 patients(30%)had developed CDMS.Thirty- eight of 84 patients with an original diagnosis of LSDMS(45%)and 17 of the remaining 100 patients with suspected MS(17%)had become CDMS.Forty-six of the 55 patients who developed CDMS in follow-up(84%)had an initial MRI that was strongly suggestive of MS.Fifty-two of those 55 CDMS patients (95%)had at least one MS-like abnormality on MRI when originally studied. In contrast,38 of 55(69%)had CSF OB,38 of 55(69%)had an abnormal VEP,35 of 55(64%)had an abnormal SEP,and 21 of 55(38%)had an abnormal CT when first studied.MRI was the most sensitive single paraclinical test for predicting CDMS.CDMS developed during follow-up in 46 of the 94 patients(49%)whose initial MRI was strongly suggestive of MS.These follow-up results confirm our previous observation that MRI is the best paraclinical test for detecting asymptomatic dissemination in space and for predicting the diagnosis of CDMS. |
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asymptomatic
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MRI,abnormal
MRI,demyelinating disease
MRI,false negative
multiple sclerosis
multiple sclerosis,asymptomatic
multiple sclerosis,diagnosis of
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