title: Imaging central veins in brain lesions with 3-T T2*-weighted magnetic resonance imaging differentiates multiple sclerosis from microangiopathic brain lesions.
abstract: White matter lesions are frequently detected using brain magnetic resonance imaging (MRI) performed for various indications. Most are microangiopathic, but demyelination, including multiple sclerosis (MS), is an important cause; conventional MRI cannot always distinguish between these pathologies. The proportion of lesions with a central vein on 7-T T2*-weighted MRI prospectively distinguishes demyelination from microangiopathic lesions.
  
  
  
  To test whether 3-T T2*-weighted MRI can differentiate MS from microangiopathic brain lesions.
  
  
  
  A total of 40 patients were studied. Initially, a test cohort of 10 patients with MS and 10 patients with microangiopathic white matter lesions underwent 3-T T2*-weighted brain MRI. Anonymised scans were analysed blind to clinical data, and simple diagnostic rules were devised. These rules were applied to a validation cohort of 20 patients (13 with MS and 7 with microangiopathic lesions) by a blinded observer.
  
  
  
  Within the test cohort, all patients with MS had central veins visible in >45% of brain lesions, while the rest had central veins visible in <45% of lesions. By applying diagnostic rules to the validation cohort, all remaining patients were correctly categorised.
  
  
  
  3-T T2*-weighted brain MRI distinguishes perivenous MS lesions from microangiopathic lesions. Clinical application of this technique could supplement existing diagnostic algorithms.
authors.affiliation: Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Niraj
authors.initials: N
authors.lastname: Mistry
authors.affiliation: Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Rasha
authors.initials: R
authors.lastname: Abdel-Fahim
authors.affiliation: Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
authors.forename: Amal
authors.initials: A
authors.lastname: Samaraweera
authors.affiliation: Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, Nottingham, UK.
authors.forename: Olivier
authors.initials: O
authors.lastname: Mougin
authors.affiliation: Department of Neurology, University Hospital of Wales, Cardiff, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Tallantyre
authors.affiliation: Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Tench
authors.affiliation: Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Jaspan
authors.affiliation: Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, Nottingham, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Morris
authors.affiliation: Department of Medical Physics, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Morgan
authors.affiliation: Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK nikos.evangelou@nottingham.ac.uk.
authors.forename: Nikos
authors.initials: N
authors.lastname: Evangelou
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D059345:Cerebral Small Vessel Diseases / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014680:Veins / Q000000981:diagnostic imaging*; D066127:White Matter / Q000000981:diagnostic imaging*
keywords: Multiple sclerosis; diagnosis; magnetic resonance imaging; sensitivity and specificity