The McDonald's criteria are MRI criteria used in the diagnosis of multiple sclerosis and were initially described in 2001 and revised in 2005. Since these initial revisions, the criteria has been revised again in 2010 and 2017.
Below are the previously used criteria, which should no longer be employed clinically.
The diagnosis of multiple sclerosis requires establishing disease disseminated in both time and space.
Disseminated in space
3 out of 4 of the following:
- 1 gadolinium-enhancing lesion or 9 T2 hyper intense brain and/or cord lesions
- 1 or more infratentorial (including cord) lesions
- 1 or more juxtacortical lesions
- 3 or more periventricular lesions
Disseminated in time
- 1 or more new gadolinium-enhancing lesions on a scan performed at least 3 months after onset of initial symptoms and at a new site
- 1 or more new hyperintense T2 lesions compared to a scan performed at least 30 days after onset of symptoms.
These imaging criteria are combined with:
- clinical signs and symptoms
- CSF oligoclonal bands
- positive visual evoked potentials
In 2005 several revisions were proposed 2 which include
- multiple spinal lesions may be a substitute for brain and infratentorial lesion criteria, as long as they are greater than 3mm in size, the length less than 2 vertebral body heights, and the lesion occupies only a portion of the cord cross section
- an enhancing spinal cord lesion may be substituted for an enhancing brain lesion
- for dissemination in time, a new T2 lesion discovery interval may be reduced from 3 months to 1 month
- 1. National MS Society
- 2. Polman CH, Reingold SC, Edan G et-al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria". Ann. Neurol. 2005;58 (6): 840-6. doi:10.1002/ana.20703 - Pubmed citation
- 3. Lövblad KO, Anzalone N, Dörfler A et-al. MR imaging in multiple sclerosis: review and recommendations for current practice. AJNR Am J Neuroradiol. 2010;31 (6): 983-9. doi:10.3174/ajnr.A1906 - Pubmed citation
- 3. Inglese M. Multiple sclerosis: new insights and trends. AJNR Am J Neuroradiol. 2006;27 (5): 954-7. AJNR Am J Neuroradiol (full text) - Pubmed citation