| Objective: With the developing of magnetic resonance imaging(MRI),the diagnosis criteria of multiple sclerosis(MS)has been changing as well.In 2016,the European collaborative research network that studies MRI in multiple sclerosis(MAGNIMS)proposed the MRI criteria for diagnosis of multiple sclerosis.O ur study was to evaluate the application of the 2016 MRI criteria of MS proposed by MAGNIMS in a large cohort of individuals with an initial clinical attack suggestive of an acute central nervous system(CNS)demyelinating disease.Methods: 140 patients with CNS demyelinating disease were recruited from the neurology department of Tianjin medical university general hospital from January 2008 to December 2016.Serum aquaporin-4 antibody was detected by cell-based assay.Serum and cerebrospinal fluid oligoclonal bands were detected by isoelectric focusing electrophoresis method.The diagnosis of MS were performed by two Neurologists based on the 2010 revised Mc Donald criteria and 2016 MAGNIMS MRI criteria respectively.Results:(1)Evaluating the application of the 2016 MRI criteria of MS proposed by MAGNIMS: 1.There were 74 patients converted to definite MS(DMS)among the 140 participants.Of these,70(50.00%)patients met the 2010 revised Mc Donald criteria while 73(52.14%)patients met the 2016 MRI criteria(P>0.05).2.70 DMS fulfilled the MRI DIS criteria of 2010 and 73 DMS fulfilled those of 2016(P>0.05);15 nonconverters fulfilled the MRI DIT criteria of 2010 and 26 fulfilled those of 2016(P>0.05).3.The median time of converting to the DMS was 18.5(6,51)months by the 2010 revised Mc Donald criteria and 12(4,33)months by the 2016 MRI criteria,P=0.049;the median attacks frequency till to DMS was 2(2,3)by the 2010 revised Mc Donald criteria and 2(2,2)by the 2016 MRI criteria,P=0.040.4.Since the disease onset,the ratio of DMS diagnosed by the 2010 revised Mc Donald criteria and the 2016 MRI criteria in 12,24,36,72 months were(42.86% vs 54.79%,P>0.05),(55.71% vs 73.97%,P=0.022),(64.29% vs 79.45%,P=0.043),and(84.29%,vs 91.78%,P>0.05).At the disease onset,there was 11.43% patients fulfilled the 2010 revised Mc Donald criteria of MS,12.33% fulfilled the 2016 MRI criteria of MS(P>0.05);after the second attacks,there was70.00% patients fulfilled the 2010 revised Mc Donald criteria of MS,86.30% fulfilled the 2016 MRI criteria of MS(P=0.018);after the third attacks,there was85.71% patients fulfilled the 2010 revised Mc Donald criteria of MS,98.63% fulfilled the 2016 MRI criteria of MS(P=0.004);after the forth and fifth attacks,there was95.71% patients fulfilled the 2010 revised Mc Donald criteria of MS,100.00% fulfilled the 2016 MRI criteria of MS(P>0.05).(2)The clinical characters of patients with MS: 1.The most common lesion in brain MRI was at periventricular(92.96%),followed by infratentorial(66.20%)and juxtacortical(29.58%)while the most common lesion in spinal MRI was at cervical cord,followed by thoracic cord.2.Motor,sensory and vision dysfunction were the more popular clinical features of the patients with MS.Among the 74 patients with MS,the most common clinical features throughout the disease duration was weakness of limbs(75.68%),followed by paresthesia(74.32%)and visual impairment(40.54%).Initial presentations most frequently included paresthesia(58.11%),followed by weakness of limbs(47.30%)and visual impairment(25.68%).Advanced nervous disorder was not so common whatever throughout the disease duration(5.41%)or in the initial presentations(2.70%).3.There was no difference about the total protein and white blood cells level in the CSF as well as the year recurrence rate between the MS patients whose EDSS not less than4 and the patients whose EDSS under the 4(P>0.05).4.There was no difference about EDSS at the acute phase,year recurrence rate,the total protein and white blood cells level in the CSF between the patients with oligoclonal bands(15 patients)and the patients without oligoclonal bands(21 patients)(P>0.05).Conclusions: 1.Compared with the 2010 revised Mc Donald criteria,the diagnosis of MS can be made in an early phase of the disease when using the 2016 MRI criteria.2.The most common lesion in brain MRI was at periventricular,followed by infratentorial and juxtacortical while the most common lesion in spinal MRI was at cervical cord,followed by thoracic cord.3.The most common clinical features of patients with MS were Motor,sensory and visual dysfunction.4.There was no difference about the total protein and white blood cells level in the CSF as well as the year recurrence rate between the patients with MS whose EDSS over the 4 and the patients whose EDSS under the 4.5.There was no difference about the acute phase EDSS,year recurrence rate,the total protein and white blood cells level in the CSF between the patients with oligoclonal bands and the patients without oligoclonal bands... |
