PURPOSE: This study aimed to assess whether post-contrast susceptibility-weighted imaging (SWI) at 1.5-T improves visualization of the central vein sign (CVS) in multiple sclerosis (MS) lesions. METHODS: In this prospective observational study, 30 patients with MS underwent 1.5-T brain magnetic resonance imaging (MRI), including pre-contrast SWI (SWI-C) and post-contrast SWI (SWI+C) sequences. Lesions were evaluated for location, contrast enhancement, and the presence of CVS and paramagnetic rim lesions (PRLs). Counts of CVS- and PRL-positive lesions were compared between SWI-C and SWI+C using the Wilcoxon signed-rank test, and the proportion of patients meeting the select-6 criterion was assessed with McNemar's test. Additional analyses using alternative thresholds (select-3 and > 50%) were performed to evaluate CVS positivity across different criteria. Correlations with Expanded Disability Status Scale (EDSS) scores were assessed using Spearman's rank correlation. RESULTS: = 0.18). No significant correlations were observed between EDSS, CVS, or PRL counts on either SWI-C or SWI+C. CONCLUSION: SWI+C at 1.5-T significantly enhances the detection of the CVS in MS lesions without substantially affecting PRL visualization, suggesting its practical value for routine clinical assessment of CVS. CLINICAL SIGNIFICANCE: SWI+C at 1.5-T, a widely accessible MRI field strength, enhances detection of the CVS in MS lesions, potentially improving diagnostic specificity in routine practice.
Atalay et al. (Fri,) studied this question.