The “central vein sign”: is there a place for susceptibility weighted imaging in possible multiple sclerosis?
- 22 February 2013
- journal article
- Published by Springer Science and Business Media LLC in European Radiology
- Vol. 23 (7), 1956-1962
- https://doi.org/10.1007/s00330-013-2791-4
Abstract
Susceptibility weighted imaging (SWI) may have the potential to depict the perivenous extent of white matter lesions (WMLs) in multiple sclerosis (MS). We aimed to assess the discriminatory value of the “central vein sign” (CVS). In a 3-T magnetic resonance imaging (MRI) study, 28 WMLs in 14 patients with at least one circumscribed lesion >5 mm and not more than eight non-confluent lesions >3 mm were prospectively included. Only WMLs in FLAIR images with a maximum diameter of >5 mm were correlated to their SWI equivalent for CVS evaluation. Five patients fulfilled the revised McDonald criteria for MS and nine patients were given alternative diagnoses. Nineteen MS-WMLs and nine non-MS-WMLs >5 mm were detected. Consensus reading found a central vein in 16 out of 19 MS-WMLs (84 %) and in one out of nine non-MS-WMLs (11 %), respectively. The CVS proved to be a highly significant discriminator (P < 0.001) between MS-WMLs and non-MS-WMLs with a sensitivity, specificity, positive and negative predictive value and accuracy of 84 %, 89 %, 94 %, 73 % and 86 %, respectively. Inter-rater agreement was good (κ = 0.77). Even though the CVS is not exclusively found in MS-WMLs, SWI may be a useful adjunct in patients with possible MS. • MRI continues to yield further information concerning MS lesions. • SWI adds diagnostic information in patients with possible MS. • The “central vein sign” was predominantly seen in MS lesions. • The “central vein sign” helps discriminate between MS and non-MS lesions.Keywords
This publication has 31 references indexed in Scilit:
- Decreased brain venous vasculature visibility on susceptibility-weighted imaging venography in patients with multiple sclerosis is related to chronic cerebrospinal venous insufficiencyBMC Neurology, 2011
- Analysis of multiple sclerosis lesions using a fusion of 3.0 T FLAIR and 7.0 T SWI phase: FLAIR SWIJournal of Magnetic Resonance Imaging, 2011
- Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteriaAnnals of Neurology, 2011
- A Comparison of 3T and 7T in the Detection of Small Parenchymal Veins Within MS LesionsInvestigative Radiology, 2009
- Diminished visibility of cerebral venous vasculature in multiple sclerosis by susceptibility‐weighted imaging at 3.0 TeslaJournal of Magnetic Resonance Imaging, 2009
- Incidental MRI anomalies suggestive of multiple sclerosisNeurology, 2009
- Seven-Tesla Magnetic Resonance ImagingArchives of Neurology, 2008
- Natural History of Multiple Sclerosis with Childhood OnsetThe New England Journal of Medicine, 2007
- Cerebral white matter lesions, vascular risk factors, and cognitive function in a population‐based studyNeurology, 1994
- New diagnostic criteria for multiple sclerosis: Guidelines for research protocolsAnnals of Neurology, 1983