Fazekas et al identified criteria for the diagnosis of multiple sclerosis (MS) in elderly patients based on MRI changes. This is particularly useful in asymptomatic patients. The authors are from Karl Franzens University in Graz, Austria.
Patient selection: > 50 years of age
Examination: T2-weighted pulse sequences
Parameters:
(1) maximum diameter for an area of increased signal (AIS) in mm
(2) location of an AIS abutting bodies of a lateral ventricle
(3) infratentorial location for an AIS
Parameter
Finding
Points
maximum AIS diameter in mm
< 6 mm
0
>= 6 mm
1
location abutting a lateral ventricular body
absent
0
present
1
infratentorial lesion(s)
absent
0
present
1
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• A score >= 2 was 100% specific and 88% sensitive for MS.
• A previously reported MRI diagnostic pattern (>=3 AIS >= 3 mm in diameter) is 96% sensitive but 59% specific.
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