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.

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Abstract

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.

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Susceptibility weighted imaging (SWI).

E. Haacke, Yingbiao Xu, Yu-Chung Cheng … (2004)

Susceptibility differences between tissues can be utilized as a new type of contrast in MRI that is different from spin density, T1-, or T2-weighted imaging. Signals from substances with different magnetic susceptibilities compared to their neighboring tissue will become out of phase with these tissues at sufficiently long echo times (TEs). Thus, phase imaging offers a means of enhancing contrast in MRI. Specifically, the phase images themselves can provide excellent contrast between gray matter (GM) and white matter (WM), iron-laden tissues, venous blood vessels, and other tissues with susceptibilities that are different from the background tissue. Also, for the first time, projection phase images are shown to demonstrate tissue (vessel) continuity. In this work, the best approach for combining magnitude and phase images is discussed. The phase images are high-pass-filtered and then transformed to a special phase mask that varies in amplitude between zero and unity. This mask is multiplied a few times into the original magnitude image to create enhanced contrast between tissues with different susceptibilities. For this reason, this method is referred to as susceptibility-weighted imaging (SWI). Mathematical arguments are presented to determine the number of phase mask multiplications that should take place. Examples are given for enhancing GM/WM contrast and water/fat contrast, identifying brain iron, and visualizing veins in the brain. Copyright 2004 Wiley-Liss, Inc.

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Small vessels in the human brain: MR venography with deoxyhemoglobin as an intrinsic contrast agent.

J Reichenbach, R Venkatesan, D Schillinger … (1997)

To assess a magnetic resonance (MR) imaging method for depicting small veins in the brain, a three-dimensional, long echo time, gradient-echo sequence that depended on the paramagnetic property of deoxyhemoglobin was used. Veins with diameters smaller than a pixel were depicted. This MR imaging method is easy to implement and may prove helpful in the evaluation of venous diseases.

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The contemporary spectrum of multiple sclerosis misdiagnosis

Orhun Kantarci, W. Tobin, Michel B. Toledano … (2016)

To characterize patients misdiagnosed with multiple sclerosis (MS).

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Author and article information

Journal

Journal ID (iso-abbrev): Nat Rev Neurol

Title: Nature reviews. Neurology

Publisher: Springer Nature

ISSN (Electronic): 1759-4766

ISSN (Print): 1759-4758

Publication date (Electronic): Dec 2016

Volume: 12

Issue: 12

Affiliations

[1 ] Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, NIH, 10 Center Drive MSC 1400, Building 10 Room 5C103, Bethesda, Maryland, USA.

[2 ] St. Michael's Hospital, University of Toronto, Ontario, Canada.

[3 ] Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA.

[4 ] Department of Diagnostic Radiology, Yale University, New Haven, Connecticut, USA.

[5 ] Division of Clinical Neuroscience, University of Nottingham, UK.

[6 ] Center for Neurological Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

[7 ] Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.

[8 ] Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

[9 ] Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

[10 ] Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy.

[11 ] Multiple Sclerosis Research Group, Department of Neurology, University of Texas Health Science Center at Houston, Texas, USA.

[12 ] Mellen Center for MS Treatment and Research, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

[13 ] Department of Pediatrics, Division of Neurology, UBC MRI Research Centre, University of British Columbia, Vancouver, Canada.

[14 ] Advanced Imaging Research Center, Oregon Health &Science University, Portland, Oregon, USA.

[15 ] Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

[16 ] Department of Pathology, Stanford University School of Medicine, Stanford, California, USA.

[17 ] Department of Neurological Sciences, University of Vermont College of Medicine, Burlington, Vermont, USA.

[18 ] Medical Image Analysis Center, University Hospital Basel, Switzerland.

[19 ] Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, New York, USA.

[20 ] Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.

[21 ] Multiple Sclerosis Center, Department of Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.

Article

Publisher Item ID: nrneurol.2016.166

DOI: 10.1038/nrneurol.2016.166

PubMed ID: 27834394

SO-VID: 4636affa-bafe-474d-bad7-15c69d29a9bc

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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.

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Electron Channelling Contrast Imaging (ECCI)

Most cited references 38

Susceptibility weighted imaging (SWI).

Small vessels in the human brain: MR venography with deoxyhemoglobin as an intrinsic contrast agent.

The contemporary spectrum of multiple sclerosis misdiagnosis

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