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

• Published in: European radiology 2013-07, Vol.23 (7), p.1956-1962
• Main Authors: Kau, Thomas, Taschwer, Manuel, Deutschmann, Hannes, Schönfelder, Martina, Weber, Jörg R., Hausegger, Klaus A.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Brain - pathology; Child; Child, Preschool; Diagnostic Radiology; Female; Humans; Image Processing, Computer-Assisted - methods; Imaging; Internal Medicine; Interventional Radiology; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Multiple sclerosis; Multiple Sclerosis - diagnosis; Multiple Sclerosis - pathology; Nerve Fibers, Myelinated - pathology; Neuro; Neuroradiology; Observer Variation; Predictive Value of Tests; Prospective Studies; Radiology; Reproducibility of Results; Ultrasound; Veins & arteries; Veins - pathology; Young Adult
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-013-2791-4

Objectives 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). Methods 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. Results 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