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

Pascal Sati; Jiwon Oh; R Todd Constable; Nikos Evangelou; Charles R G Guttmann; Roland G Henry; Eric C Klawiter; Caterina Mainero; Luca Massacesi; Henry McFarland; Flavia Nelson; Daniel Ontaneda; Alexander Rauscher; William D Rooney; Amal P R Samaraweera; Russell T Shinohara; Raymond A Sobel; Andrew J Solomon; Constantina A Treaba; Jens Wuerfel; Robert Zivadinov; Nancy L Sicotte; Daniel Pelletier; Daniel S Reich; NAIMS Cooperative

doi:10.1038/nrneurol.2016.166

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

Nat Rev Neurol. 2016 Dec;12(12):714-722. doi: 10.1038/nrneurol.2016.166. Epub 2016 Nov 11.

Authors

Pascal Sati¹, Jiwon Oh^{2

3}, R Todd Constable⁴, Nikos Evangelou⁵, Charles R G Guttmann⁶, Roland G Henry⁷, Eric C Klawiter⁸, Caterina Mainero⁹, Luca Massacesi¹⁰, Henry McFarland¹, Flavia Nelson¹¹, Daniel Ontaneda¹², Alexander Rauscher¹³, William D Rooney¹⁴, Amal P R Samaraweera⁵, Russell T Shinohara¹⁵, Raymond A Sobel¹⁶, Andrew J Solomon¹⁷, Constantina A Treaba⁹, Jens Wuerfel¹⁸, Robert Zivadinov¹⁹, Nancy L Sicotte²⁰, Daniel Pelletier²¹, Daniel S Reich¹; NAIMS Cooperative

Affiliations

¹ Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, NIH, 10 Center Drive MSC 1400, Building 10 Room 5C103, Bethesda, Maryland, USA.
² St. Michael's Hospital, University of Toronto, Ontario, Canada.
³ Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA.
⁴ Department of Diagnostic Radiology, Yale University, New Haven, Connecticut, USA.
⁵ Division of Clinical Neuroscience, University of Nottingham, UK.
⁶ Center for Neurological Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
⁷ Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.
⁸ Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
⁹ Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
¹⁰ Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy.
¹¹ Multiple Sclerosis Research Group, Department of Neurology, University of Texas Health Science Center at Houston, Texas, USA.
¹² Mellen Center for MS Treatment and Research, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
¹³ Department of Pediatrics, Division of Neurology, UBC MRI Research Centre, University of British Columbia, Vancouver, Canada.
¹⁴ Advanced Imaging Research Center, Oregon Health &Science University, Portland, Oregon, USA.
¹⁵ Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
¹⁶ Department of Pathology, Stanford University School of Medicine, Stanford, California, USA.
¹⁷ Department of Neurological Sciences, University of Vermont College of Medicine, Burlington, Vermont, USA.
¹⁸ Medical Image Analysis Center, University Hospital Basel, Switzerland.
¹⁹ Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, New York, USA.
²⁰ Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
²¹ Multiple Sclerosis Center, Department of Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.

PMID: 27834394
DOI: 10.1038/nrneurol.2016.166

Abstract

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 (CVS) has recently been proposed as a novel MRI biomarker to improve the accuracy and speed of MS diagnosis. Evidence indicates that the presence of the CVS in individual lesions can accurately differentiate MS from other diseases that mimic this condition. However, the predictive value of the CVS for the development of clinical MS in patients with suspected demyelinating disease is still unknown. Moreover, the lack of standardization for the definition and imaging of the CVS currently limits its clinical implementation and validation. On the basis of a thorough review of the existing literature on the CVS and the consensus opinion of the members of the North American Imaging in Multiple Sclerosis (NAIMS) Cooperative, this article provides statements and recommendations aimed at helping radiologists and neurologists to better understand, refine, standardize and evaluate the CVS in the diagnosis of MS.

Publication types

Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
Review

MeSH terms

Cerebral Veins / diagnostic imaging*
Consensus*
Humans
Magnetic Resonance Imaging*
Multiple Sclerosis / diagnostic imaging*
Practice Guidelines as Topic / standards*
Societies, Medical / standards*

Grants and funding

MC_PC_12019/MRC_/Medical Research Council/United Kingdom