Abstract
BackgroundConventional brain MRI cannot always distinguish between different white matter lesions. Susceptibility weighted imaging (SWI) can detect a sign called central vein sign which is suggested to discriminate between multiple sclerosis and other white matter lesions thus increasing the accuracy of MRI in MS diagnosis. This study aimed to evaluate the role of MR susceptibility weighted imaging in differentiating MS from CSVD lesions.ResultsThe central vein sign (CVS) was found to have a premium diagnostic performance in diagnosis of MS with sensitivity 83.3%, specificity 70%, positive predictive value 80.6%, and negative predictive value 73.7%. When CVS positive lesions load was ≥ 44.24%, the specificity of CVS in diagnosing MS raised to 100%.ConclusionDetection of the CVS on SWI can reliably discriminate between MS and CSVD.
Highlights
Conventional brain Magnetic resonance imaging (MRI) cannot always distinguish between different white matter lesions
Regarding the pathogenesis of Multiple sclerosis (MS) lesions, they were found to be typically perivenular, so special MR sequences were used to detect the veins within the MS plaques [6], this feature is called the “central vein sign,” that would increase the accuracy of MRI in MS diagnosis [7]
The other 20 patients (including 6 females and 14 males with mean age 61.40 ± 10.34 years) were known to have ischemic white matter lesions related to cerebral small-vessel disease
Summary
Conventional brain MRI cannot always distinguish between different white matter lesions. Susceptibility weighted imaging (SWI) can detect a sign called central vein sign which is suggested to discriminate between multiple sclerosis and other white matter lesions increasing the accuracy of MRI in MS diagnosis. MRI is a common investigation which can support a clinical diagnosis of MS by detecting lesions in the brain and spinal cord [2]. It can be used for monitoring the disease activity which helps to guide treatment decision and to decrease relapse occurrence and disease progression [3, 4]. Susceptibility-weighted imaging is one of the new MR sequences which can draw a venous map of the brain and can show the central vein in MS lesions [5] Regarding the pathogenesis of MS lesions, they were found to be typically perivenular, so special MR sequences were used to detect the veins within the MS plaques [6], this feature is called the “central vein sign,” that would increase the accuracy of MRI in MS diagnosis [7].
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