The central vein sign in the diagnosis of multiple sclerosis
https://doi.org/10.14412/2074-2711-2024-2-14-18
Abstract
Objective: to determine the specificity and sensitivity of the central vein sign (CVS) for the diagnosis of multiple sclerosis (MS).
Material and methods. We analyzed 76 patients. The main group consisted of 40 patients with a confirmed diagnosis of MS according to the McDonald criteria, 2017. The comparison group included 20 patients with migraine and 16 patients with cerebral microangiopathy. All patients underwent a standardized MRI scan of the brain, including 3D FLAIR and SWI modes. The total number of T2/FLAIR hyperintense lesions in the brain and the number of lesions with CVS were calculated.
Results. In the group of MS patients, the total and relative number of lesions with CVS was higher than in the comparison group (p<0.001). The 40% lesion rule had a sensitivity of 97.5% and a specificity of 94.4%. The sensitivity of the 3-lesion rule was 92.5% and the specificity 66.7%. The use of the 5-lesion rule had a sensitivity of 75% and a specificity of 83.7%.
Conclusion. The data obtained indicate a significant diagnostic role for SCV in MS. The use of the 5-lesion rule provides high sensitivity and specificity with relative ease of use.
About the Authors
Sh. R. Nabiev
A.Ya. Kozhevnikov Clinic of Nervous System Diseases, Department of Nervous System Diseases and Neurosurgery, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
11, Rossolimo St., Build. 1, Moscow 119021
Competing Interests:
The investigation has not been sponsored. There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors.
S. A. Dzhukkaeva
A.Ya. Kozhevnikov Clinic of Nervous System Diseases, Department of Nervous System Diseases and Neurosurgery, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
11, Rossolimo St., Build. 1, Moscow 119021
Competing Interests:
The investigation has not been sponsored. There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors.
M. Sh. Asvedov
A.Ya. Kozhevnikov Clinic of Nervous System Diseases, Department of Nervous System Diseases and Neurosurgery, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
11, Rossolimo St., Build. 1, Moscow 119021
Competing Interests:
The investigation has not been sponsored. There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors.
O. N. Voskresenskaya
A.Ya. Kozhevnikov Clinic of Nervous System Diseases, Department of Nervous System Diseases and Neurosurgery, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Competing Interests:
Russian Federation
11, Rossolimo St., Build. 1, Moscow 119021
Competing Interests:
The investigation has not been sponsored. There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors.
References
1. Ramagopalan SV, Sadovnick AD. Epidemiology of multiple sclerosis. Neurol Clin. 2011 May;29(2):207-17. doi: 10.1016/j.ncl.2010.12.010
2. Boyko A, Smirnova N, Petrov S, et al. Epidemiology of MS in Russia, a historical review. Mult Scler Demyelinating Disord. 2016;(1):13. doi: 10.1186/s40893-016-0016-9
3. Goodin DS. The epidemiology of multiple sclerosis: insights to disease pathogenesis. Handb Clin Neurol. 2014;122:231-66. doi: 10.1016/B978-0-444-52001-2.00010-8
4. Solomon AJ, Naismith RT, Cross AH. Misdiagnosis of multiple sclerosis: Impact of the 2017 McDonald criteria on clinical practice. Neurology. 2019 Jan 1;92(1):26-33. doi: 10.1212/WNL.0000000000006583. Epub 2018 Oct 31.
5. Mamykina SA, Voskresenskaya ON, Shmidt TE, Grinyuk VV. Bilateral horizontal gaze palsy as the only manifestation of demyelination in the central nervous system. Rossiyskiy nevrologicheskiy zhurnal = Russian Neurological Journal. 2022;27(4):81-5. doi: 10.30629/2658-7947-2022-27-4-81-85 (In Russ.).
6. Belov SE, Gubskiy IL, Lelyuk VG, Boyko AN. Central vein sign for differential diagnosis of demyelinating diseases of CNS. Meditsina ekstremal'nykh situatsiy. 2021;23(3):131-5. doi: 10.47183/mes.2021.021 (In Russ.).
7. Chaaban L, Safwan N, Moussa H, et al. Central vein sign: A putative diagnostic marker for multiple sclerosis. Acta Neurol Scand. 2022 Mar;145(3):279-87. doi: 10.1111/ane.13553. Epub 2021 Nov 18.
8. Belov SE, Boyko AN. The central vein sign in the differential diagnosis of multiple sclerosis. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2020;12(Suppl. 1):29-32. doi: 10.14412/2074-2711-2020-1S-29-32 (In Russ.).
9. Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17(2):162-73. doi:10.1016/S1474-4422(17)30470-2
10. Mistry N, Dixon J, Tallantyre E, et al. Central veins in brain lesions visualized with high-field magnetic resonance imaging: a pathologically specific diagnostic biomarker for inflammatory demyelination in the brain. JAMA Neurol. 2013 May;70(5):623-8. doi: 10.1001/jamaneurol.2013.1405
11. Cortese R, Magnollay L, Tur C, et al. Value of the central vein sign at 3T to differentiate MS from seropositive NMOSD. Neurology. 2018 Apr 3;90(14):e1183-e1190. doi: 10.1212/WNL.0000000000005256. Epub 2018 Mar 7.
12. Daboul L, O’Donnell CM, Amin M, et al. A multicenter pilot study evaluating simplified central vein assessment for the diagnosis of multiple sclerosis. Mult Scler. 2024 Jan;30(1):25-34. doi: 10.1177/13524585231214360. Epub 2023 Dec 13.
13. Cagol A, Cortese R, Barakovic M, et al; MAGNIMS Study Group. Diagnostic Performance of Cortical Lesions and the Central Vein Sign in Multiple Sclerosis. JAMA Neurol. 2024 Feb 1;81(2):143-53. doi: 10.1001/jamaneurol.2023.4737
Review
For citations:
Nabiev SR, Dzhukkaeva SA, Asvedov MS, Voskresenskaya ON. The central vein sign in the diagnosis of multiple sclerosis. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2024;16(2):14-18. (In Russ.) https://doi.org/10.14412/2074-2711-2024-2-14-18
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