The central vein sign in multiple sclerosis patients with vascular comorbidities

  title={The central vein sign in multiple sclerosis patients with vascular comorbidities},
  author={François Guisset and Valentina Lolli and C{\'e}line Bugli and Gaetano Perrotta and Julie Absil and Bernard Dachy and Caroline Pot and Marie Th{\'e}audin and Marco Pasi and Vincent van Pesch and Pietro Maggi},
  journal={Multiple Sclerosis Journal},
  pages={1057 - 1065}
Background: The central vein sign (CVS) is an imaging biomarker able to differentiate multiple sclerosis (MS) from other conditions causing similar appearance lesions on magnetic resonance imaging (MRI), including cerebral small vessel disease (CSVD). However, the impact of vascular risk factors (VRFs) for CSVD on the percentage of CVS positive (CVS+) lesions in MS has never been evaluated. Objective: To investigate the association between different VRFs and the percentage of CVS+ lesions in MS… 
8 Citations
Central Vein Sign Profile of Newly Developing Lesions in Multiple Sclerosis: A 3-Year Longitudinal Study.
In a cohort of adults with MS followed over a median duration of 3 years, most newly developing T2 or enhancing lesions were CVS+ (68%), and nearly half (48%) developed newCVS+ lesions only.
Central vein sign: A putative diagnostic marker for multiple sclerosis.
The existing literature on CVS is reviewed to evaluate its added value in the diagnosis of MS and usefulness in differentiating it from other vasculopathies and identify available automated CVS assessment methods.
The Use of the Central Vein Sign in the Diagnosis of Multiple Sclerosis: A Systematic Review and Meta-analysis
The meta-analysis performed shows that the use of the CVS in differentiating MS from other mimicking diseases is encouraged; moreover, theUse of dedicated sequences such as 3D-EPI and the high MRI field is beneficial.
Central vein sign and iron rim in multiple sclerosis: ready for clinical use?
The assessment of the CVS and iron rim lesions is feasible in the clinical scenario and provides MRI measures specific to MS pathological substrates, improving diagnosis and prognosis of these patients.
Stronger Microstructural Damage Revealed in Multiple Sclerosis Lesions with Central Vein Sign by Quantitative Gradient Echo MRI
Gradient Echo Plural Contrast Imaging (GEPCI) MRI is used to simultaneously visualize CVS and measure tissue damage in MS lesions to examine CVS in relation to tissue integrity in white matter lesions and among MS subtypes.
Paramagnetic Rim Lesions are Specific to Multiple Sclerosis: An International Multicenter 3T MRI Study
Paramagnetic rim lesions, rare in other neurological conditions, yielded high specificity in differentiating MS from non‐MS, and future prospective multicenter studies should validate their role as a diagnostic biomarker.
Characteristics of secondary progressive multiple sclerosis: Disease activity and provision of care in Germany - A registry-based/multicentric cohort study.
To assess the real-world situation in monitoring disease activity in SPMS patients and to identify associations of resulting subgroups with demographics, symptomatology, and therapy, the active, inactive, and unclassifiable patients were compared.
Walk Your Talk: Real-World Adherence to Guidelines on the Use of MRI in Multiple Sclerosis
Although the MS community is getting closer to a standardization of MRI protocols, there is still a relatively wide heterogeneity among NR, with particular reference to contrast administration, which must be overcome to guarantee an adequate quality of patients’ care in MS.


Diagnostic performance of central vein sign for multiple sclerosis with a simplified three-lesion algorithm
A simplified determination of CVS in three white matter lesions on 3T FLAIR* MRI demonstrated good specificity and sensitivity and fair inter-rater reliability for a diagnosis of MS and with further study, may be a candidate for clinical application.
Evaluation of the Central Vein Sign as a Diagnostic Imaging Biomarker in Multiple Sclerosis.
Use of the central vein sign at 3T MRI yielded a high specificity and a moderate sensitivity in differentiating MS from not MS; international, multicenter studies may be needed to ascertain whether thecentral vein sign-based criteria can accurately detect MS.
Distinct influence of different vascular risk factors on white matter brain lesions in multiple sclerosis
Individual VRF appear to affect MS-specific lesions differently, and an increase in MS lesions was mainly seen in smokers; however, this VRF is most likely to be present from onset of MS, and other VRF effects may be partly mitigated by treatment.
The central vein sign and its clinical evaluation for the diagnosis of multiple sclerosis: a consensus statement from the North American Imaging in Multiple Sclerosis Cooperative
Over the past few years, MRI has become an indispensable tool for diagnosing multiple sclerosis (MS). However, the current MRI criteria for MS diagnosis have imperfect sensitivity and specificity.
The “central vein sign” in patients with diagnostic “red flags” for multiple sclerosis: A prospective multicenter 3T study
The CVS detected on 3T FLAIR* images can accurately predict an MS diagnosis in patients suspected to have MS, but with atypical clinical, laboratory, and imaging features.
CVSnet: A machine learning approach for automated central vein sign assessment in multiple sclerosis
A deep learning‐based prototype for automated assessment of the CVS in white matter MS lesions using data from three different imaging centers shows promising performance in differentiating MS from its mimics.
Central vein sign differentiates Multiple Sclerosis from central nervous system inflammatory vasculopathies
In a multicenter study, the frequency of perivenular lesions in MS versus systemic autoimmune diseases with CNS involvement and primary angiitis of the CNS (PACNS) is assessed.
Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis
Patients with MS with one or more CV risks showed increased lesion burden and more advanced brain atrophy and association with MRI outcomes was examined.
Perivascular spaces--MRI marker of inflammatory activity in the brain?
The data points to an association of VRS with CEL as a sign for inflammation rather than with factors such as age, observed in healthy controls, and therefore suggests a role ofVRS in inflammatory processes of the brain.
Imaging central veins in brain lesions with 3-T T2*-weighted magnetic resonance imaging differentiates multiple sclerosis from microangiopathic brain lesions
3-T T2*-weighted brain MRI distinguishes perivenous MS lesions from microangiopathic lesions, and clinical application of this technique could supplement existing diagnostic algorithms.