The "central vein sign": is there a place for susceptibility weighted imaging in possible multiple sclerosis?

This study group from Austria assessed the discriminatory value of the “central vein sign” (CVS) in a subset of patients where the susceptibility weighted imaging (SWI) feature may possibly add to the differential diagnostic characterisation of defined MS-WMLs (white matter lesions) and non-MS-WMLs at the time of first imaging.

Using 3T MRI, 28 WMLs in 14 patients with at least one circumscribed lesion >5mm and not more than 8 non-confluent lesions >3mm were included. From this, five patients fulfilled the revised McDonald criteria for MS and nine patients were given alternative diagnoses.

Nineteen MS-WMLs and nine non-MS-WMLs >5mm were detected. A central vein was found in 84% of the MS-WMLs and 11% of the non-WMLs. The CVS was a highly significant discriminator (P<0.001) between MS-WMLs and non-MS-WMLs. Therefore, in conclusion, the CVS is not exclusively found in MS-WMLs, SWI may be a useful adjunct in patients with possible MS.

Authors: Kau T, Taschwer M, Deutschmann H

Source: Eur Radiol. 2013 Feb 22. [Epub ahead of print]

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