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European Radiology

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01-07-2013 | Neuro

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

Authors: Thomas Kau, Manuel Taschwer, Hannes Deutschmann, Martina Schönfelder, Jörg R. Weber, Klaus A. Hausegger

Published in: European Radiology | Issue 7/2013

Abstract

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 < 0.001) between MS-WMLs and non-MS-WMLs with a sensitivity, specificity, positive and negative predictive value and accuracy of 84 %, 89 %, 94 %, 73 % and 86 %, respectively. Inter-rater agreement was good (κ = 0.77).

Conclusions

Even though the CVS is not exclusively found in MS-WMLs, SWI may be a useful adjunct in patients with possible MS.

Key Points

• MRI continues to yield further information concerning MS lesions.

• SWI adds diagnostic information in patients with possible MS.

• The “central vein sign” was predominantly seen in MS lesions.

• The “central vein sign” helps discriminate between MS and non-MS lesions.

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Title: The “central vein sign”: is there a place for susceptibility weighted imaging in possible multiple sclerosis?
Authors: Thomas Kau
Manuel Taschwer
Hannes Deutschmann
Martina Schönfelder
Jörg R. Weber
Klaus A. Hausegger
Publication date: 01-07-2013
Publisher: Springer-Verlag
Published in: European Radiology / Issue 7/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-2791-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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