Criteria for an increased specificity of MRI interpretation in elderly subjects with suspected multiple sclerosis

We reviewed the MRIs of 49 asymptomatic volunteers (age range, 31 to 77 years) and of 50 MS patients (age range, 14 to 63) for areas of increased signal (AIS) and features discriminating MS lesions from lesions seen with normal aging. We obtained optimal specificity of MRI interpretation (100%) if we required at least two of the following three AIS features — size ≥6 mm, abutting ventricular bodies, infratentorial location — for a positive MRI diagnosis of MS. Applying these criteria to the MRIs of elderly patients with suspected MS should significantly improve specificity (p < 0.001) over current quantitative criteria (at least three AIS≥3 mm) without significantly decreasing sensitivity.