American Journal of Neuroradiology, Vol 16, Issue 2 259-264, Copyright © 1995 by American Society of Neuroradiology
ARTICLES |
The effect of gadolinium on the sensitivity and specificity of MR in the initial diagnosis of multiple sclerosis
MW Tas, F Barkhol, MA van Walderveen, CH Polman, OR Hommes and J Valk
Department of Diagnostic Radiology, Free University Hospital, Amsterdam, The Netherlands.
PURPOSE: To determine whether gadolinium can improve the sensitivity and specificity of MR imaging for the initial diagnosis of multiple sclerosis. METHODS: Patients (n = 57) with neurologic symptoms suggesting multiple sclerosis were studied prospectively. MR imaging consisted of T2-weighted and gadolinium-enhanced T1-weighted spin-echo images. Lumbar puncture was performed for cerebrospinal fluid analysis in 34 patients. RESULTS: After imaging, 17 patients (35%) had clinically definite multiple sclerosis. Cerebrospinal fluid examination had a sensitivity of 69% and specificity of 38%. Using liberal criteria, the sensitivity of T2-weighted MR imaging was 94% and the specificity 55%; using more strict criteria, the specificity increased to 65% with a sensitivity of 88%. Gadopentetate dimeglumine enhancement increased the specificity further to 80% with a loss of sensitivity (59%). CONCLUSION: Gadolinium enhancement increases the specificity of MR imaging in the early diagnosis of multiple sclerosis.
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