The central vein sign in the differential diagnosis of multiple sclerosis

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OBJECTIVE

To carry out a clinical and radiological assessment of the central vein sign (CVS) as a diagnostic marker for multiple sclerosis (MS) and other demyelinating and non-demyelinating diseases with focal brain damage, using clinical and laboratory examination data, as well as MRI.

MATERIAL AND METHODS

The results of clinical and neuroradiological examination of 107 patients diagnosed with MS or with other diseases accompanied by focal brain damage according to MRI data were analyzed.

RESULTS

CVS is a sensitive but low-specific diagnostic marker of MS. According to our data, the sensitivity and specificity of 40 and 50% of the threshold of perivenular lesions in the diagnosis of MS are the same and amount to 100% and 39.4%, respectively. Neither the type of MS course, nor the severity of the course, nor the intake of DMT (disease modifying treatment), affect the proportion of foci with CVS. The spread of the proportion of foci with CVS in patients with MS was 60—100%. The proportion of foci with CVS is below 40 and 50% of the threshold in patients with demyelinating and non-demyelinating diseases (NMOSD, migraine, systemic lupus erythematosus, Susak disease, CLIPPERS), which allows for differential diagnosis with MS. The proportion of foci with CVS comparable to MS in patients with acute disseminated encephalomyelitis, small vessel disease, as well as in patients with radiologically isolated syndrome does not allow using this symptom in the differential diagnosis of these conditions.

CONCLUSION

The use of CVS as a diagnostic marker of MS is possible only in combination with the already existing diagnostic criteria of MS.

Keywords:

multiple sclerosis

MRI

diagnosis

central vein sign

Authors:

Belov S.E.

Pirogov Russian National Research Medical University

ORCID: 0000-0002-4373-2215

Boyko A.N.

Pirogov Russian National Research Medical University;
Federal Center for Brain Research and Neurotechnology

SPIN RSCI: 9921-9109
Scopus AuthorID: 7102247663
ORCID: 0000-0002-2975-4151

Dolgushin M.B.

Federal Center for Brain Research and Neurotechnology

ORCID: 0000-0003-3930-5998

Received:

01.05.2024

Accepted:

13.05.2024

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