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“Central Vein Sign” has potential in MS diagnosis, European study shows

Detecting changes to the brain’s central vein using magnetic resonance imaging (MRI) scans is a useful and accurate strategy to enhance diagnosis of MS, a new study shows.

Analysis of more than 4,000 brain lesions, obtained from contrast-enhanced MRI scans collected from eight neuroimaging European centres, showed that detection of the so-called central vein sign (CVS) was able to differentiate patients with MS, including those with clinically isolated syndrome (CIS), from non-MS patients with similar brain lesions. The study, “Evaluation of the Central Vein Sign as a Diagnostic Imaging Biomarker in Multiple Sclerosis”, was published in the journal JAMA Neurology.

Central Vein Sign (CVS) has been proposed as a way to differentiate MS from other conditions that have brain imaging features similar to those seen in MS patients. CVS refers to the visualisation of such veins inside brain lesions, which is thought to reflect the loss of nerve cells’ myelin protective sheath due to inflammation (demyelination) and may aid the diagnosis of MS. The diagnostic value of CVS, however, remains to be proven in a broader setting, across multiple centres and a variety of imaging protocols.

Researchers conducted a study across multiple sites in Europe, to evaluate if CVS detected by standard 3T MRI scans could be used to discriminate MS from other non-MS conditions that echo MS brain lesions.

Results revealed that a CVS positive sign was found in 1,335 (47.4%) of 2,815 relapsing remitting multiple sclerosis (RRMS) lesions and in 374 (54.2%) of 690 CIS lesions. In contrast, CVS was detected in 148 of 942 non-MS lesions (15.7%), a finding consistent among all studied non-MS subgroups.

The findings of the latest study reinforce CVS as a promising marker to support MS diagnosis. Researchers now will call for larger, prospective studies with people suspected of MS, to confirm the clinical utility of this MRI signal.

Source: MS-UK 02/09/19

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