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Published on: June 2, 2015
Central vein sign for multiple sclerosis: A systematic review and meta-analysis
A Bhandari1, H Xiang2, J Lechner-Scott3
1Department of Anatomy, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia; Townsville University Hospital, Townsville, Queensland, Australia.
Aims:
To systematically review the diagnostic value of the central vein sign (CVS) in multiple sclerosis (MS) and to meta-analyse the proportion of positive lesions for CVS needed to distinguish MS from non-MS mimics.
Materials And Methods:
A literature review was performed and a proportion meta-analysis was performed to examine the proportion of the CVS in MS lesions. Studies reporting a threshold of the CVS containing lesions with 100% diagnostic accuracy were included in the meta-analysis. This was compared to MS mimics in order to establish the discriminative value of the CVS.
Results:
The CVS was found to be viable at lower field strengths (3 T and 1.5 T) and automated analysis is currently less accurate than manual counting. Five studies were included for the proportional meta-analysis. From the analysis, a proportion of 45% of lesions having the CVS was suggested given that the findings that the weighted proportion was 46.4% (95% confidence interval [CI]: of 40.3%-52.6%) with low heterogeneity (I2 = 0.0%; p=0.5).
Conclusion:
Although the CVS is a clinically relevant and viable sign, further work is needed to integrate this into the existing diagnostic criteria. As manual determination is a time-consuming process, the development of automated methods will be beneficial. With improvements in computational imaging techniques, the CVS will have an important role in the diagnosis and differentiation of MS.
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