Related Experiment Video
Updated: Jul 26, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Central vein sign and paramagnetic rim sign: From radiologically isolated syndrome to multiple sclerosis
Tatiana Abou Mrad1, Kim Naja1, Samia J Khoury2
1Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Abstract:
The widespread use of magnetic resonance imaging (MRI) has led to an increase in incidental findings in the central nervous system. Radiologically isolated syndrome (RIS) is a condition where imaging reveals lesions suggestive of demyelinating disease without any clinical episodes consistent with multiple sclerosis (MS). The prognosis for RIS patients is uncertain, with some remaining asymptomatic while others progress to MS. Several risk factors for disease progression have been identified, including male sex, younger age at diagnosis, and spinal cord lesions. This article reviews two promising biomarkers, the central vein sign (CVS) and the paramagnetic rim sign (PRS), and their potential role in the diagnosis and prognosis of MS and RIS. Both CVS and PRS have been shown to be accurate diagnostic markers in MS, with high sensitivity and specificity, and have been useful in distinguishing MS from other disorders. Further research is needed to validate these findings and determine the clinical utility of these biomarkers in routine practice.
Insights
Radiologically isolated syndrome (RIS) shows brain lesions on MRI without symptoms. New biomarkers, central vein sign (CVS) and paramagnetic rim sign (PRS), show promise for diagnosing and predicting multiple sclerosis (MS) progression in RIS patients.
Area of Science:
- Neurology
- Radiology
- Biomarker Research
Background:
- Magnetic resonance imaging (MRI) increases incidental central nervous system findings.
- Radiologically isolated syndrome (RIS) presents as demyelinating lesions on MRI without clinical symptoms of multiple sclerosis (MS).
- Prognosis for RIS patients is variable, with some progressing to MS.
Purpose of the Study:
- To review the diagnostic and prognostic potential of two biomarkers: the central vein sign (CVS) and the paramagnetic rim sign (PRS).
- To assess the role of CVS and PRS in distinguishing MS from other disorders and predicting MS progression in RIS.
- To highlight the need for further validation of these biomarkers in clinical practice.
Main Methods:
- Literature review of studies investigating CVS and PRS in MS and RIS.
- Analysis of diagnostic accuracy (sensitivity and specificity) of CVS and PRS in MS.
- Examination of risk factors for MS progression in RIS patients.
Main Results:
- CVS and PRS demonstrate high accuracy as diagnostic markers for MS.
- These biomarkers aid in differentiating MS from other neurological conditions.
- Identified risk factors for MS progression include male sex, younger age, and spinal cord lesions.
Conclusions:
- CVS and PRS are promising biomarkers for MS diagnosis and prognosis.
- Further research is required to validate their clinical utility in routine practice for RIS patients.
- Biomarker-assisted diagnosis could improve management of patients with incidental CNS findings.
Related Concept Videos
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:27Assessment of the Cardiovascular System III: Palpation
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation