Analysis of more than 4,000 brain lesions, obtained from contrast-enhanced MRI scans collected from eight neuroimaging European centers, 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.
Researchers also explored the best criteria and imaging protocols to apply in the clinic. More studies are now warranted to confirm CVS application in clinical practice.
The study, “Evaluation of the Central Vein Sign as a Diagnostic Imaging Biomarker in Multiple Sclerosis,” was published in the journal JAMA Neurology.
The region surrounding brain’s central vessels is thought to be a site where inflammation is more likely to outbreak, leading to lesions around these veins (known as perivenous lesions) that can be detected by MRI scan.
CVS refers to the visualization of such veins inside brain lesions, which is thought to reflect 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 centers and a variety of imaging protocols.
Most findings supporting this application come from ultra high-field MRI studies, using high resolution scanners that operate at field strengths of 7 Tesla, or 7T, and above. These scanners are not available at most clinics, which normally operate with 1.5T or 3T instruments.
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