NEUROLOGY 1988;38:1822
© 1988 American Academy of Neurology
Criteria for an increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis
F. Fazekas,
H. Offenbacher,
S. Fuchs,
R. Schmidt,
K. Niederkorn,
S. Horner and
H. Lechner
Department of Neurology and Psychiatry, Karl-Franzerns University, Graz, Austria.
We reviewed the MRIs of 49 asymptomatic volunteers (age range, 31 to 77 years) and of 50 MS patients (age range, 14 to 63) for areas of increased signal (AIS) and features discriminating MS lesions from lesions seen with normal aging. We obtained optimal specificity of MRI interpretation (100%) if we required at least two of the following three AIS features — size  6 mm, abutting ventricular bodies, infratentorial location — for a positive MRI diagnosis of MS. Applying these criteria to the MRIs of elderly patients with suspected MS should significantly improve specificity (p < 0.001) over current quantitative criteria (at least three AIS3 mm) without significantly decreasing sensitivity.
Address correspondence and reprint requests to Dr. Fazekas, Department of Neurology and Psychiatry, Karl-Franzens University, Auenbruggerplatz 22, A-8036 Graz, Austria.
Received April 26, 1988. Accepted for publication in final form June 14, 1988.
This article has been cited by other articles:
|
|
|
|
 
X. Montalban, M. Tintore, J. Swanton, F. Barkhof, F. Fazekas, M. Filippi, J. Frederiksen, L. Kappos, J. Palace, C. Polman, et al.
MRI criteria for MS in patients with clinically isolated syndromes
Neurology,
February 2, 2010;
74(5):
427 - 434.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A Siva, S Saip, A Altintas, A Jacob, B. Keegan, and O. Kantarci
Multiple sclerosis risk in radiologically uncovered asymptomatic possible inflammatory-demyelinating disease
Multiple Sclerosis,
August 1, 2009;
15(8):
918 - 927.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. Rovira, J. Swanton, M. Tintore, E. Huerga, F. Barkhof, M. Filippi, J. L. Frederiksen, A. Langkilde, K. Miszkiel, C. Polman, et al.
A Single, Early Magnetic Resonance Imaging Study in the Diagnosis of Multiple Sclerosis
Arch Neurol,
May 1, 2009;
66(5):
587 - 592.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Rocca, E Pagani, B Colombo, P Tortorella, A Falini, G Comi, and M Filippi
Selective Diffusion Changes of The Visual Pathways in Patients with Migraine: A 3-T Tractography Study
Cephalalgia,
October 1, 2008;
28(10):
1061 - 1068.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F Di Pauli, M Reindl, R Ehling, F Schautzer, C Gneiss, A Lutterotti, E. O'Reilly, K. Munger, F Deisenhammer, A Ascherio, et al.
Smoking is a risk factor for early conversion to clinically definite multiple sclerosis
Multiple Sclerosis,
September 1, 2008;
14(8):
1026 - 1030.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. F. Lucchinetti, R. H. Gavrilova, I. Metz, J. E. Parisi, B. W. Scheithauer, S. Weigand, K. Thomsen, J. Mandrekar, A. Altintas, B. J. Erickson, et al.
Clinical and radiographic spectrum of pathologically confirmed tumefactive multiple sclerosis
Brain,
July 1, 2008;
131(7):
1759 - 1775.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Tomassini, L. De Giglio, M. Reindl, P. Russo, I. Pestalozza, P. Pantano, T. Berger, and C. Pozzilli
Anti-myelin antibodies predict the clinical outcome after a first episode suggestive of MS
Multiple Sclerosis,
November 1, 2007;
13(9):
1086 - 1094.
[Abstract]
[PDF]
|
|
|
|
|
|
|
B. Banwell, M. Shroff, J. M. Ness, D. Jeffery, S. Schwid, B. Weinstock-Guttman, and for the International Pediatric MS Study Group
MRI features of pediatric multiple sclerosis
Neurology,
April 17, 2007;
68(16_suppl_2):
S46 - S53.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S Rauer, B Euler, M Reindl, and T Berger
Antimyelin antibodies and the risk of relapse in patients with a primary demyelinating event.
J. Neurol. Neurosurg. Psychiatry,
June 1, 2006;
77(6):
739 - 742.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M A Rocca, A Ceccarelli, A Falini, P Tortorella, B Colombo, E Pagani, G Comi, G Scotti, and M Filippi
Diffusion tensor magnetic resonance imaging at 3.0 tesla shows subtle cerebral grey matter abnormalities in patients with migraine
J. Neurol. Neurosurg. Psychiatry,
May 1, 2006;
77(5):
686 - 689.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J Brettschneider, A Petzold, A Junker, and H Tumani
Axonal damage markers in the cerebrospinal fluid of patients with clinically isolated syndrome improve predicting conversion to definite multiple sclerosis
Multiple Sclerosis,
April 1, 2006;
12(2):
143 - 148.
[Abstract]
[PDF]
|
|
|
|
|
|
|
P. Pantano, C. Mainero, D. Lenzi, F. Caramia, G. D. Iannetti, M. C. Piattella, I. Pestalozza, S. Di Legge, L. Bozzao, and C. Pozzilli
A longitudinal fMRI study on motor activity in patients with multiple sclerosis
Brain,
September 1, 2005;
128(9):
2146 - 2153.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I F Pestalozza, C Pozzilli, S Di Legge, M C Piattella, P Pantano, F Caramia, P Pasqualetti, and G L Lenzi
Monthly brain magnetic resonance imaging scans in patients with clinically isolated syndrome
Multiple Sclerosis,
August 1, 2005;
11(4):
390 - 394.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C. H Polman, J. S Wolinsky, and S. C Reingold
Multiple sclerosis diagnostic criteria: three years later
Multiple Sclerosis,
February 1, 2005;
11(1):
5 - 12.
[Abstract]
[PDF]
|
|
|
|
|
|
|
R. Bakshi, G. J. Hutton, J. R. Miller, and E.-W. Radue
The use of magnetic resonance imaging in the diagnosis and long-term management of multiple sclerosis
Neurology,
December 14, 2004;
63(11_suppl_5):
S3 - S11.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
C. D. Hahn, M. M. Shroff, S. I. Blaser, and B. L. Banwell
MRI criteria for multiple sclerosis: Evaluation in a pediatric cohort
Neurology,
March 9, 2004;
62(5):
806 - 808.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Sastre-Garriga, M. Tintore, A. Rovira, C. Nos, J. Rio, A. J. Thompson, and X. Montalban
Specificity of Barkhof Criteria in Predicting Conversion to Multiple Sclerosis When Applied to Clinically Isolated Brainstem Syndromes
Arch Neurol,
February 1, 2004;
61(2):
222 - 224.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. C.J. Bot, F. Barkhof, C. H. Polman, G.J. L. a Nijeholt, V. de Groot, E. Bergers, H. J. Ader, and J. A. Castelijns
Spinal cord abnormalities in recently diagnosed MS patients: Added value of spinal MRI examination
Neurology,
January 27, 2004;
62(2):
226 - 233.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Okamoto, S. Tokiguchi, T. Furusawa, K. Ishikawa, A. F. Quardery, S. Shinbo, and K. Sasai
MR Features of Diseases Involving Bilateral Middle Cerebellar Peduncles
AJNR Am. J. Neuroradiol.,
November 1, 2003;
24(10):
1946 - 1954.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V Zipoli, E Portaccio, G Siracusa, G Pracucci, S Sorbi, and M P Amato
Interobserver agreement on Poser's and the new McDonald's diagnostic criteria for multiple sclerosis
Multiple Sclerosis,
October 1, 2003;
9(5):
481 - 485.
[Abstract]
[PDF]
|
|
|
|
|
|
|
E. M. Frohman, D. S. Goodin, P. A. Calabresi, J. R. Corboy, P. K. Coyle, M. Filippi, J. A. Frank, S. L. Galetta, R. I. Grossman, K. Hawker, et al.
The utility of MRI in suspected MS: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology
Neurology,
September 9, 2003;
61(5):
602 - 611.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Berger, P. Rubner, F. Schautzer, R. Egg, H. Ulmer, I. Mayringer, E. Dilitz, F. Deisenhammer, and M. Reindl
Antimyelin Antibodies as a Predictor of Clinically Definite Multiple Sclerosis after a First Demyelinating Event
N. Engl. J. Med.,
July 10, 2003;
349(2):
139 - 145.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S Di Legge, M C Piattella, C Pozzilli, P Pantano, F Caramia, I F Pestalozza, A Paolillo, and G L Lenzi
Longitudinal evaluation of depression and anxiety in patients with clinically isolated syndrome at high risk of developing early multiple sclerosis
Multiple Sclerosis,
June 1, 2003;
9(3):
302 - 306.
[Abstract]
[PDF]
|
|
|
|
|
|
|
G V McDonnell, J Cabrera-Gomez, D B Calne, D K. Li, and J Oger
Clinical presentation of primary progressive multiple sclerosis 10 years after the incidental finding of typical magnetic resonance imaging brain lesions: The subclinical stage of primary progressive multiple sclerosis may last 10 years
Multiple Sclerosis,
April 1, 2003;
9(2):
204 - 209.
[Abstract]
[PDF]
|
|
|
|
|
|
|
J Sastre-Garriga, M Tintore, A Rovira, E Grive, I Pericot, M Comabella, A J Thompson, and X Montalban
C onversion to multiple sclerosis after a clinically isolated syndrome of the brainstem: cranial magnetic resonance imaging, cerebrospinal fl uid and neurophysiological findings
Multiple Sclerosis,
February 1, 2003;
9(1):
39 - 43.
[Abstract]
[PDF]
|
|
|
|
|
|
|
I Nakashima, K Fujihara, T Misu, J Fujimori, S Sato, S Takase, and Y Itoyama
A comparative study of Japanese multiple sclerosis patients with and without oligoclonal IgG bands
Multiple Sclerosis,
December 1, 2002;
8(6):
459 - 462.
[Abstract]
[PDF]
|
|
|
|
|
|
|
CHAMPS Study Group
MRI predictors of early conversion to clinically definite MS in the CHAMPS placebo group
Neurology,
October 8, 2002;
59(7):
998 - 1005.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. O'Connor
Key issues in the diagnosis and treatment of multiple sclerosis: An overview
Neurology,
September 24, 2002;
59(90063):
S1 - 33.
[Full Text]
|
|
|
|
|
|
|
M. Rovaris, M. Holtmannspotter, M. Rocca, G. Iannucci, M. Codella, B. Viti, A. Campi, G. Comi, T. Yousry, and M. Filippi
Contribution of cervical cord MRI and brain magnetization transfer imaging to the assessment of individual patients with multiple sclerosis: a preliminary study
Multiple Sclerosis,
September 1, 2002;
8(1_suppl):
52 - 58.
[Abstract]
[PDF]
|
|
|
|
|
|
|
H. McFarland
The emerging role of MRI in multiple sclerosis and the new diagnostic criteria
Multiple Sclerosis,
September 1, 2002;
8(1_suppl):
71 - 72.
[PDF]
|
|
|
|
|
|
|
CHAMPS Study Group
Baseline MRI characteristics of patients at high risk for multiple sclerosis: results from the CHAMPS trial
Multiple Sclerosis,
August 1, 2002;
8(4):
330 - 338.
[Abstract]
[PDF]
|
|
|
|
|
|
|
P. Pantano, G. D. Iannetti, F. Caramia, C. Mainero, S. Di Legge, L. Bozzao, C. Pozzilli, and G. L. Lenzi
Cortical motor reorganization after a single clinical attack of multiple sclerosis
Brain,
July 1, 2002;
125(7):
1607 - 1615.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. L. Arnold and P.M. Matthews
MRI in the diagnosis and management of multiple sclerosis
Neurology,
April 23, 2002;
58(90084):
S23 - 31.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
M Rovaris, M Holtmannspotter, M A Rocca, G Iannucci, M Codella, B Viti, A Campi, G Comi, T A Yousry, and M Filippi
Contribution of cervical cord MRI and brain magnetization transfer imaging to the assessment of individual patients with multiple sclerosis: a preliminary study
Multiple Sclerosis,
February 1, 2002;
8(1):
52 - 58.
[Abstract]
[PDF]
|
|
|
|
|
|
|
H F McFarland
The emerging role of MRI in multiple sclerosis and the new diagnostic criteria
Multiple Sclerosis,
February 1, 2002;
8(1):
71 - 72.
[PDF]
|
|
|
|
|
|
|
M. Inglese, F. Salvi, G. Iannucci, G. L. Mancardi, M. Mascalchi, and M. Filippi
Magnetization Transfer and Diffusion Tensor MR Imaging of Acute Disseminated Encephalomyelitis
AJNR Am. J. Neuroradiol.,
February 1, 2002;
23(2):
267 - 272.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Inglese, A. Ghezzi, S. Bianchi, S. Gerevini, M. P. Sormani, V. Martinelli, G. Comi, and M. Filippi
Irreversible Disability and Tissue Loss in Multiple Sclerosis: A Conventional and Magnetization Transfer Magnetic Resonance Imaging Study of the Optic Nerves
Arch Neurol,
February 1, 2002;
59(2):
250 - 255.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M Tintore, A Rovira, L Brieva, E Grive, R Jardi, C Borras, and X Montalban
Isolated demyelinating syndromes: comparison of CSF oligoclonal bands and different MR imaging criteria to predict conversion to CDMS
Multiple Sclerosis,
December 1, 2001;
7(6):
359 - 363.
[Abstract]
[PDF]
|
|
|
|
|
|
|
L. Belopitova, V. Guergueltcheva, and V. Bojinova
Definite and Suspected Multiple Sclerosis in Children: Long-Term Follow-up and Magnetic Resonance Imaging Findings
J Child Neurol,
May 1, 2001;
16(5):
317 - 324.
[Abstract]
[PDF]
|
|
|
|
|
|
|
P. Cabre, O. Heinzlef, H. Merle, G.G. Buisson, O. Bera, R. Bellance, J.C. Vernant, and D. Smadja
MS and neuromyelitis optica in Martinique (French West Indies)
Neurology,
February 27, 2001;
56(4):
507 - 514.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K Bashir and J N Whitaker
Importance of paraclinical and CSF studies in the diagnosis of MS in patients presenting with partial cervical transverse myelopathy and negative cranial MRI
Multiple Sclerosis,
October 1, 2000;
6(5):
312 - 316.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M Filippi
Enhanced magnetic resonance imaging in multiple sclerosis
Multiple Sclerosis,
October 1, 2000;
6(5):
320 - 326.
[Abstract]
[PDF]
|
|
|
|
|
|
|
J. S. Kaiser, R. I. Grossman, M. Polansky, J. K. Udupa, Y. Miki, and S. L. Galetta
Magnetization Transfer Histogram Analysis of Monosymptomatic Episodes of Neurologic Dysfunction: Preliminary Findings
AJNR Am. J. Neuroradiol.,
June 1, 2000;
21(6):
1043 - 1047.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
M Kremenchutzky, D Lee, G P A Rice, and G C Ebers
Diagnostic brain MRI findings in primary progressive multiple sclerosis
Multiple Sclerosis,
April 1, 2000;
6(2):
81 - 85.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. Tintore, A. Rovira, M. J. Martinez, J. Rio, P. Diaz-Villoslada, L. Brieva, C. Borras, E. Grive, J. Capellades, and X. Montalban
Isolated Demyelinating Syndromes: Comparison of Different MR Imaging Criteria to Predict Conversion to Clinically Definite Multiple Sclerosis
AJNR Am. J. Neuroradiol.,
April 1, 2000;
21(4):
702 - 706.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
M. Filippi, M. A. Rocca, M. Wiessmann, S. Mennea, M. Cercignani, T. A. Yousry, M. P. Sormani, and G. Comi
A Comparison of MR Imaging with Fast-FLAIR, HASTE-FLAIR, and EPI-FLAIR Sequences in the Assessment of Patients with Multiple Sclerosis
AJNR Am. J. Neuroradiol.,
November 1, 1999;
20(10):
1931 - 1938.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
G. Mastronardo, M. A. Rocca, G. Iannucci, C. Pereira, and M. Filippi
A Longitudinal MR Study of the Presymptomatic Phase in a Patient with Clinically Definite Multiple Sclerosis
AJNR Am. J. Neuroradiol.,
August 1, 1999;
20(7):
1268 - 1272.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
F. Fazekas, F. Barkhof, M. Filippi, R. I. Grossman, D. K. B. Li, W. I. McDonald, H. F. McFarland, D. W. Paty, J. H. Simon, J. S. Wolinsky, et al.
The contribution of magnetic resonance imaging to the diagnosis of multiple sclerosis
Neurology,
August 1, 1999;
53(3):
448 - 448.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Filippi, M. A. Rocca, L. Minicucci, V. Martinelli, A. Ghezzi, R. Bergamaschi, and G. Comi
Magnetization transfer imaging of patients with definite MS and negative conventional MRI
Neurology,
March 1, 1999;
52(4):
845 - 845.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
S. J. Khoury and H. L. Weiner
Multiple Sclerosis: What Have We Learned From Magnetic Resonance Imaging Studies?
Arch Intern Med,
March 23, 1998;
158(6):
565 - 573.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. L Frederiksen and C. J. Sindic
Intrathecal synthesis of virus-specific oligoclonal IgG, and of free kappa and free lambda oligoclonal bands in acute monosymptomatic optic neuritis. Comparison with brain MRI
Multiple Sclerosis,
February 1, 1998;
4(1):
22 - 26.
[Abstract]
[PDF]
|
|
|
|
|
|
|
D. E. Goodkin, R. A. Rudick, and J. S. Ross
The Use of Brain Magnetic Resonance Imaging in Multiple Sclerosis
Arch Neurol,
May 1, 1994;
51(5):
505 - 516.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. I. Mushlin, A. S. Detsky, C. E. Phelps, P. W. O'Connor, D. K. Kido, W. Kucharczyk, D. W. Giang, C. Mooney, C. M. Tansey, W. J. Hall, et al.
The Accuracy of Magnetic Resonance Imaging in Patients With Suspected Multiple Sclerosis
JAMA,
June 23, 1993;
269(24):
3146 - 3151.
[Abstract]
[PDF]
|
|
|
|
|
|
|
K. R. R. Krishnan
Neuroanatomic Substrates of Depression in the Elderly
J Geriatr Psychiatry Neurol,
January 1, 1993;
6(1):
39 - 58.
[Abstract]
[PDF]
|
|
|
|
|
|
|
D. E. Goodkin, T. H. Doolittle, S. S. Hauser, R. M. Ransohoff, A. D. Roses, and R. A. Rudick
Diagnostic Criteria for Multiple Sclerosis Research Involving Multiply Affected Families
Arch Neurol,
August 1, 1991;
48(8):
805 - 807.
[Abstract]
[PDF]
|
|
|
|
|
|
|
J. C. J. Bot, F. Barkhof, G. L. a Nijeholt, D. van Schaardenburg, A. E. Voskuyl, H. J. Ader, J. A. L. Pijnenburg, C. H. Polman, B. M. J. Uitdehaag, E. G. J. Vermeulen, et al.
Differentiation of Multiple Sclerosis from Other Inflammatory Disorders and Cerebrovascular Disease: Value of Spinal MR Imaging
Radiology,
April 1, 2002;
223(1):
46 - 56.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
