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Comparing MRI Criteria for Diagnosing Pediatric MS and ADEM

Posted Jul 15 2010 12:00am
Information found below was suggested by Cherie C. Binns RN BS MSCN

The new Callen criteria for multiple sclerosis–acute disseminated encephalomyelitis (MS-ADEM) are the most useful of the current MRI criteria for differentiating a first attack of MS from monophasic ADEM in children, according to a study in the May 4 Neurology. In comparison, although the Callen diagnostic MS criteria are more sensitive, they lack the specificity necessary to differentiate MS from ADEM, researchers reported.

I. A. Ketelslegers, MD, and colleagues from Erasmus MC, Department of Neurology, Rotterdam, the Netherlands, included 49 children with a demyelinating event and an MRI scan within two months of their first clinical attack. A total of 21 children had ADEM and were relapse-free after at least two years of follow-up, and 28 patients had received a definitive diagnosis of MS. The investigators assessed the sensitivity and specificity of the four current sets of MRI criteria—Barkhof criteria, Kids with Multiple Sclerosis (KIDMUS) criteria, Callen MS-ADEM criteria, and Callen diagnostic MS criteria.

The researchers found that the Callen MS-ADEM criteria had the best combination of sensitivity (75%) and specificity (95%). Although the KIDMUS criteria had a higher specificity (100%), they provided a much lower sensitivity (11%). The Barkhof criteria yielded a sensitivity of 61% and a specificity of 91%. Furthermore, the Callen diagnostic MS criteria were the most sensitive (82%), but they were 52% specific for distinguishing a first attack of MS from ADEM, according to the researchers.

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