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Lesion size and shape in central vein sign assessment for multiple sclerosis diagnosis: An in vivo and postmortem MRI study.
Al-Louzi, Omar; Manukyan, Sargis; Donadieu, Maxime; Absinta, Martina; Letchuman, Vijay; Calabresi, Brent; Desai, Parth; Beck, Erin S; Roy, Snehashis; Ohayon, Joan; Pham, Dzung L; Thomas, Anish; Jacobson, Steven; Cortese, Irene; Auluck, Pavan K; Nair, Govind; Sati, Pascal; Reich, Daniel S.
Affiliation
  • Al-Louzi O; Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA; Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Manukyan S; Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA; Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Donadieu M; Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
  • Absinta M; Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD; USA/IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy.
  • Letchuman V; Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
  • Calabresi B; Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
  • Desai P; Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
  • Beck ES; Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • Roy S; Section on Neural Function, National Institute of Mental Health, Bethesda, MD, USA.
  • Ohayon J; Neuroimmunology Clinic, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
  • Pham DL; Center for Neuroscience and Regenerative Medicine, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
  • Thomas A; Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
  • Jacobson S; Viral Immunology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
  • Cortese I; Neuroimmunology Clinic, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
  • Auluck PK; Human Brain Collection Core, National Institute of Mental Health, Bethesda, MD, USA.
  • Nair G; Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
  • Sati P; Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA; Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Reich DS; Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
Mult Scler ; 28(12): 1891-1902, 2022 10.
Article in En | MEDLINE | ID: mdl-35674284
BACKGROUND: The "central vein sign" (CVS), a linear hypointensity on T2*-weighted imaging corresponding to a central vein/venule, is associated with multiple sclerosis (MS) lesions. The effect of lesion-size exclusion criteria on MS diagnostic accuracy has not been extensively studied. OBJECTIVE: Investigate the optimal lesion-size exclusion criteria for CVS use in MS diagnosis. METHODS: Cross-sectional study of 163 MS and 51 non-MS, and radiological/histopathological correlation of 5 MS and 1 control autopsy cases. The effects of lesion-size exclusion on MS diagnosis using the CVS, and intralesional vein detection on histopathology were evaluated. RESULTS: CVS+ lesions were larger compared to CVS- lesions, with effect modification by MS diagnosis (mean difference +7.7 mm3, p = 0.004). CVS percentage-based criteria with no lesion-size exclusion showed the highest diagnostic accuracy in differentiating MS cases. However, a simple count of three or more CVS+ lesions greater than 3.5 mm is highly accurate and can be rapidly implemented (sensitivity 93%; specificity 88%). On magnetic resonance imaging (MRI)-histopathological correlation, the CVS had high specificity for identifying intralesional veins (0/7 false positives). CONCLUSION: Lesion-size measures add important information when using CVS+ lesion counts for MS diagnosis. The CVS is a specific biomarker corresponding to intralesional veins on histopathology.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Multiple Sclerosis Type of study: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Mult Scler Journal subject: NEUROLOGIA Year: 2022 Type: Article Affiliation country: United States
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Multiple Sclerosis Type of study: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Mult Scler Journal subject: NEUROLOGIA Year: 2022 Type: Article Affiliation country: United States