A DGReview of :"Predictive
Value of Lesions for Relapses in Relapsing-remitting Multiple Sclerosis"
American Journal
of Neuroradiology02/26/2001
By Veronica Rose
Researchers were unable to find any magnetic resonance markers to predict precisely an impending relapse in patients with remitting multiple sclerosis.
However, they found an association between the absence of magnetic resonance markers and fewer relapses, indicating a more favorable outcome, according to a report from Germany.
Researchers at Heidelburg's Ruprecht-Kurls University designed a study to determine whether exacerbation of relapsing-remitting multiple sclerosis (RRMS) could be accurately predicted by enhancing lesions, new enhancing lesions and new hypointense lesions (black holes) within a period of six months.
The study followed suggestions that enhancing lesions on contrast-enhanced Tl-weighted magnetic resonance imaging (MRI) were capable of predicting impending exacerbation in patients with RRMS.
Participants included 50 patients with RRMS, who underwent monthly MRI and clinical examinations for 12 months. Putative predictions of clinical relapses were defined from enhancing lesions, new enhancing lesions and new black hole outcomes, including a study of their operating characteristics.
The positive predictive values for an exacerbation of enhancing lesions, new enhancing lesions or black holes did not exceed 0.25 and the negative values were all close to 0.9.
The occurrence of
new enhancing lesions in each of the previous three months (PV + 0.79 [95
percent confidence interval, 0.651-0.900] PV-0.83 [95 percent CI, 0.751-0.887])
were the best predictions, while presence of new black holes in the two
previous months could accurately predict new black holes (PV+ 0.54 [95
percent CI 0.372-0.697] PV -0.85 [95 percent CI 0.790-0.896]).
American Journal
of Neuroradiology 2001 Vol22 pp 281-291. "Predictive
Value of Lesions for Relapses in Relapsing-remitting Multiple Sclerosis"