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.
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.
Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, NIH, 10 Center Drive MSC 1400, Building 10 Room 5C103, Bethesda, Maryland, USA.
Pascal
P
Sati
St. Michael's Hospital, University of Toronto, Ontario, Canada.|Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA.
Jiwon
J
Oh
Department of Diagnostic Radiology, Yale University, New Haven, Connecticut, USA.
R Todd
RT
Constable
Division of Clinical Neuroscience, University of Nottingham, UK.
Nikos
N
Evangelou
Center for Neurological Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Charles R G
CR
Guttmann
Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.
Roland G
RG
Henry
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Eric C
EC
Klawiter
Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Caterina
C
Mainero
Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy.
Luca
L
Massacesi
Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, NIH, 10 Center Drive MSC 1400, Building 10 Room 5C103, Bethesda, Maryland, USA.
Henry
H
McFarland
Multiple Sclerosis Research Group, Department of Neurology, University of Texas Health Science Center at Houston, Texas, USA.
Flavia
F
Nelson
Mellen Center for MS Treatment and Research, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Daniel
D
Ontaneda
Department of Pediatrics, Division of Neurology, UBC MRI Research Centre, University of British Columbia, Vancouver, Canada.
Alexander
A
Rauscher
Advanced Imaging Research Center, Oregon Health &Science University, Portland, Oregon, USA.
William D
WD
Rooney
Division of Clinical Neuroscience, University of Nottingham, UK.
Amal P R
AP
Samaraweera
Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Russell T
RT
Shinohara
Department of Pathology, Stanford University School of Medicine, Stanford, California, USA.
Raymond A
RA
Sobel
Department of Neurological Sciences, University of Vermont College of Medicine, Burlington, Vermont, USA.
Andrew J
AJ
Solomon
Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Constantina A
CA
Treaba
Medical Image Analysis Center, University Hospital Basel, Switzerland.
Jens
J
Wuerfel
Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, New York, USA.
Robert
R
Zivadinov
Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Nancy L
NL
Sicotte
Multiple Sclerosis Center, Department of Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
Daniel
D
Pelletier
Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, NIH, 10 Center Drive MSC 1400, Building 10 Room 5C103, Bethesda, Maryland, USA.
Daniel S
DS
Reich
D002550:Cerebral Veins / Q000000981:diagnostic imaging*; D032921:Consensus; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging*; D017410:Practice Guidelines as Topic / Q000592:standards*; D012955:Societies, Medical / Q000592:standards*