November 11, 2016Nature Reviews Neurology427 citationsOpen Access
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
Key Result
The central vein sign on MRI has the potential to accurately differentiate multiple sclerosis from other demyelinating diseases, prompting consensus recommendations for its standardized radiological definition and future clinical evaluation.
Structured PICO
Does the central vein sign on MRI improve the accuracy and speed of multiple sclerosis diagnosis compared to current MRI criteria?
P
Population
Patients with suspected demyelinating disease or multiple sclerosis
E
Exposure
Central vein sign (CVS) evaluation on MRI
C
Comparator
Current MRI criteria for MS diagnosis
O
Outcome
Accuracy and speed of multiple sclerosis diagnosissurrogate
This consensus statement provides a standardized roadmap for evaluating the central vein sign on MRI to improve the diagnostic accuracy of multiple sclerosis.
Limitations
- Lack of standardization for the definition and imaging of the central vein sign
- Dearth of large-scale prospective multicenter studies evaluating the central vein sign for MS diagnosis
- Most existing studies include small cohorts of patients with already known diagnoses
- Predictive value of the CVS for the development of clinical MS in patients with suspected demyelinating disease is still unknown
- Lack of standardization for the definition and imaging of the CVS currently limits its clinical implementation and validation
Abstract
The central vein sign (CVS) has been proposed as a novel MRI biomarker to improve the accuracy and speed of multiple sclerosis (MS) diagnosis. This Consensus Statement from the NAIMS Cooperative provides a roadmap to help radiologists and neurologists to better understand, refine, standardize and evaluate the CVS in the diagnosis of MS. 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.
Cite This Study
Sati et al. (2016) conducted a review in Multiple Sclerosis. Central vein sign (CVS) on MRI was evaluated. The central vein sign on MRI has the potential to accurately differentiate multiple sclerosis from other demyelinating diseases, prompting consensus recommendations for its standardized radiological definition and future clinical evaluation.