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Paul O'Connor, MD, MSc, FRCPC; Catherine Tansey, MSc; Walter Kucharczyk, MD, FRCPC; Allan S. Detsky, MD, PhD, FRCPC; Rochester-Toronto MRI Study Group

Arch Neurol. 1994;51(1):53-59.

Abstract
Background and Methods
We performed a randomized trial of the incremental impact of high-volume contrast computed tomographic scan of the brain plus trimodal evoked potentials vs magnetic resonance imaging of the brain on neurologists' diagnostic labeling of patients with suspected multiple sclerosis (MS). Two hundred and four patients with suspected MS (clinically possible 59% or probable 41%McAlpine criteria) were assessed by two neurologists. Patients were diagnostically categorized after reviewing the results of the tests presented in random order.

Results
Most of the change in diagnostic categorization occurred after presenting the first test result irrespective of result sequence (X²=0.01, P=.99). The diagnoses became more definitive when all test results were available (P<.001). Magnetic resonance imaging and evoked potential were suggestive of MS equally frequently (X²=0.57, P=.45).

Conclusion
In suspected MS, there is no difference in diagnostic effect between brain magnetic resonance image scanning and computed tomography plus trimodal evoked potentials.

Author Affiliations
From the Rochester-Toronto MRI Study Group, Universities of Rochester (NY) and Toronto (Ontario), the MS Clinic, Divisions of Neurology (Dr O'Connor), General Internal Medicine, and Clinical Epidemiology (Dr Detsky), and Department of Radiology (Ms Tansey and Dr Kucharczyk), University of Toronto.

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