J Clin Neurol.  2018 Jul;14(3):339-344. 10.3988/jcn.2018.14.3.339.

Applicability of McDonald 2010 and Magnetic Resonance Imaging in Multiple Sclerosis (MAGNIMS) 2016 Magnetic Resonance Imaging Criteria for the Diagnosis of Multiple Sclerosis in Sri Lanka

• Gamage SM
• Wijeweera
• Wijesinghe P
• Adikari SB
• Fink K
• Sominanda

• KMID: 2415050
• DOI: http://doi.org/10.3988/jcn.2018.14.3.339

Abstract

BACKGROUND AND PURPOSE
The magnetic resonance imaging in multiple sclerosis (MAGNIMS) group recently proposed guidelines to replace the existing dissemination-in-space criteria in McDonald 2010 magnetic resonance imaging (MRI) criteria for diagnosing multiple sclerosis. There has been insufficient research regarding their applicability in Asians. Objective of this study was to determine the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of McDonald 2010 and MAGNIMS 2016 MRI criteria with the aim of verifying their applicability in Sri Lankan patients.
METHODS
Patients with clinically isolated syndrome diagnosed by consultant neurologists were recruited from five major neurology centers. Baseline and follow-up MRI scans were performed within 3 months from the initial presentation and at one year after baseline MRI, respectively. McDonald 2010 and MAGNIMS 2016 MRI criteria were applied to all MRI scans. Patients were followed-up for 2 years to assess the conversion to clinically definite multiple sclerosis (CDMS). The sensitivity, specificity, accuracy, PPV, and NPV for predicting the conversion to CDMS were calculated.
RESULTS
Forty-two of 66 patients converted to CDMS. Thirty-seven fulfilled the McDonald 2010 MRI criteria, and 33 converted to CDMS. MAGNIMS 2016 MRI criteria were fulfilled by 29, with 28 converting to CDMS. The sensitivity, specificity, accuracy, PPV, and NPV were 78%, 83%, 64%, 89%, and 69%, respectively, for the McDonald 2010 criteria, and 67%, 96%, 77%, 96%, and 62% for the MAGNIMS 2016 MRI criteria.
CONCLUSIONS
MAGNIMS 2016 MRI criteria were superior to McDonald 2010 MRI criteria in specificity, accuracy, and PPV, but inferior in sensitivity and NPV.

Keyword

multiple sclerosis; McDonald 2010 magnetic resonance imaging criteria; magnetic resonance imaging in multiple sclerosis 2016 magnetic resonance imaging criteria; McDonald 2017 magnetic resonance imaging criteria; performance; Asia

MeSH Terms

Asia
Asian Continental Ancestry Group
Consultants
Diagnosis*
Follow-Up Studies
Humans
Magnetic Resonance Imaging*
Multiple Sclerosis*
Neurology
Sensitivity and Specificity
Sri Lanka*

Figure

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  Fig. 1 Magnetic resonance imaging scans of McDonald 2010 true-positive (A), false-positive (B), and false-negative (C) patients.

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  Fig. 2 Presenting clinical manifestations in the study population. MAGNIMS: magnetic resonance imaging in multiple sclerosis.

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