Multiple Sclerosis, December
2001, vol. 7, no. 6, pp. 359-363(5)
Aim of the study:
To evaluate and compare the capacity
of oligoclonal bands (OB) and three sets of MR imaging criteria to predict
the conversion of clinically isolated syndromes (CIS) to clinically definite
multiple sclerosis (CDMS).
Patients and methods:
One hundred and twelve patients with
CIS were prospectively studied with MR imaging and determination of OB.
Based on the clinical follow-up (conversion or not conversion to CDMS),
we calculated the sensitivity, specificity accuracy, positive and negative
predictive value of the OB, and MR imaging criteria proposed by Paty et
al, Fazekas et al and Barkhof et al.
Results:
CDMS developed in 26 (23.2%) patients
after a mean follow-up of 31 months (range 12 – 62). OB were positive in
70 (62.5%) patients and were associated with a higher risk of developing
CDMS. OB showed a sensitivity of 81%, specificity of 43%, accuracy of 52%,
positive predictive value (PPV) of 30% and negative predictive value (NPV)
of 88%. Paty and Fazekas criteria showed the same results with a sensitivity
of 77%, specificity of 51%, accuracy of 57%, positive predictive value
of 32% and negative predictive value of 88%. Barkhof criteria showed a
sensitivity of 65%, specificity of 70%, accuracy of 69%, PPV of 40% and
NPV of 87%. The greatest accuracy was achieved when patients with positive
OB and three or four Barkhof's criteria were selected.
Conclusions:
We observed a high prevalence of
OB in CIS. OB and MR imaging (Paty's and Fazekas' criteria) have high sensitivity.
Barkhof's criteria have a higher specificity. Both OB and MR imaging criteria
have a high negative predictive value.
© 2002 ingenta
Tintoré M. [1] *; Rovira
A. [2]; Brieva L. [1]; Grivé E. [2]; Jardí R. [3]; Borrás
C. [1]; Montalban X. [1]
[1] Unit of Clinical Neuroimmunology
(Department of Neurology), Vall d'Hebron University Hospitals, Barcelona,
Spain [2] Magnetic Resonance Unit (Department of Radiology), Vall d'Hebron
University Hospitals, Barcelona, Spain [3] Department of Biochemistry,
Vall d'Hebron University Hospitals, Barcelona, Spain [*] Correspondence:
Mar Tintoré, Unit of Clinical Neuroimmunology, Escola d'Enfermeria
5a planta, Hospital General Universitari Vall d'Hebron, Pg Vall d'Hebron
119-129, 08035 Barcelona, Spain
Abstract: