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Department of Neurology and Psychiatry, Karl-Franzerns University, Graz, Austria.
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 AIS3 mm) without significantly decreasing sensitivity.
Address correspondence and reprint requests to Dr. Fazekas, Department of Neurology and Psychiatry, Karl-Franzens University, Auenbruggerplatz 22, A-8036 Graz, Austria.
Received April 26, 1988. Accepted for publication in final form June 14, 1988.
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