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© 2024. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Objective

The radiologically isolated syndrome (RIS) represents the earliest detectable preclinical phase of multiple sclerosis (MS). Increasing evidence suggests that the central vein sign (CVS) enhances lesion specificity, allowing for greater MS diagnostic accuracy. This study evaluated the diagnostic performance of the CVS in RIS.

Methods

Patients were prospectively recruited in a single tertiary center for MS care. Participants with RIS were included and compared to a control group of sex and age-matched subjects. All participants underwent 3 Tesla magnetic resonance imaging, including postcontrast susceptibility-based sequences, and the presence of CVS was analyzed. Sensitivity and specificity were assessed for different CVS lesion criteria, defined by proportions of lesions positive for CVS (CVS+) or by the absolute number of CVS+ lesions.

Results

180 participants (45 RIS, 45 MS, 90 non-MS) were included, representing 5285 white matter lesions. Among them, 4608 were eligible for the CVS assessment (970 in RIS, 1378 in MS, and 2260 in non-MS). According to independent ROC comparisons, the proportion of CVS+ lesions performed similarly in diagnosing RIS from non-MS than MS from non-MS (p = 0.837). When a 6-lesion CVS+ threshold was applied, RIS lesions could be diagnosed with an accuracy of 87%. MS could be diagnosed with a sensitivity of 98% and a specificity of 83%. Adding OCBs or Kappa index to CVS biomarker increased the specificity to 100% for RIS diagnosis.

Interpretation

This study shows evidence that CVS is an effective imaging biomarker in differentiating RIS from non-MS, with similar performances to those in MS.

Details

Title
The diagnostic value of the central vein sign in radiologically isolated syndrome
Author
Landes-Chateau, Cassandre 1   VIAFID ORCID Logo  ; Levraut, Michael 2   VIAFID ORCID Logo  ; Okuda, Darin T 3   VIAFID ORCID Logo  ; Themelin, Albert 4 ; Cohen, Mikael 5   VIAFID ORCID Logo  ; Kantarci, Orhun H 6   VIAFID ORCID Logo  ; Siva, Aksel 7   VIAFID ORCID Logo  ; Pelletier, Daniel 8 ; Mondot, Lydiane 9   VIAFID ORCID Logo  ; Lebrun-Frenay, Christine 5   VIAFID ORCID Logo 

 Université Cote d'Azur, UMR2CA (URRIS), Nice, France 
 Université Cote d'Azur, UMR2CA (URRIS), Nice, France; Service de Médecine Interne, Centre Hospitalier Universitaire de Nice, Nice, France 
 The University of Texas Southwestern Medical Center, Dallas, Texas, USA 
 Service de Radiologie, Centre Hospitalier Universitaire de Nice, Nice, France 
 Université Cote d'Azur, UMR2CA (URRIS), Nice, France; Service de Neurologie, Centre de Ressource et de Compétence Sclérose en Plaques (CRC-SEP), Centre Hospitalier Universitaire de Nice, Nice, France 
 Mayo Clinic, Rochester, Minnesota, USA 
 Istanbul University, Cerrahpasa School of Medicine, Istanbul, Turkey 
 University of South California, San Francisco, California, USA 
 Université Cote d'Azur, UMR2CA (URRIS), Nice, France; Service de Radiologie, Centre Hospitalier Universitaire de Nice, Nice, France 
Pages
662-672
Section
Research Articles
Publication year
2024
Publication date
Mar 2024
Publisher
John Wiley & Sons, Inc.
e-ISSN
23289503
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2981217474
Copyright
© 2024. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.