The Central Vein Sign as a Guidepost for Diagnosing Multiple Sclerosis

To reveal veins in the central nervous system (CNS), susceptibility-weighted MRI is useful by virtue of showing deoxyhemoglobin as a hypointense signal. Prior studies have consistently demonstrated hypointense venules within the white matter lesions characteristic of multiple sclerosis (MS). Now, investigators have evaluated this “central vein sign” as a specific marker of demyelinating disease compared with systemic inflammatory or autoimmune diseases (SADs) such as systemic lupus erythematosus, antiphospholipid syndrome, Sjögren syndrome, and primary angiitis of the CNS.

Median number of MRI lesions was 15 in both relapsing remitting MS (52 patients) and SADs (31 patients), but median lesion volume was 34% smaller in patients with SADs. Le…