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Updated: Jun 12, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Role of central vein sign in multiple sclerosis management: a systematic literature review
Justyna Wołos1,2, Olga Grodzka3,4, Jan Kochanowski3
1Department of Neurology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Warsaw, Poland. justyna.wolos@wum.edu.pl.
Introduction:
Multiple sclerosis (MS) is known to be an inflammatory disease of the central nervous system (CNS), with its typical neuropathological characteristics being demyelinating white matter lesions, relative preservation of axons, and astrogliosis. Although the criteria for MS diagnosis have been regularly updated, two main elements have remained unchanged: the obligatory proof for dissemination of pathological lesions in both time and space. However, not all presentations are clear, and doubts about the diagnosis sometimes arise. The central vein sign (CVS) is a neuroimaging feature that has attracted growing interest in terms of MS diagnosis, differentiation, and general management. The evidence regarding the use of CVS as an MS imaging marker has accumulated rapidly, with diverse CVS assessment rules being proposed for implementation into the diagnostic criteria.
Material And Methods:
We aimed to thoroughly assess the utility of CVS in MS management. A systematic review was conducted according to the Preferred Research Items for Systematic Reviews and Metanalyses (PRISMA 2020) guidelines. The PubMed and Embase databases were searched, and, after detailed analysis, 48 of the most recent studies were included in this review.
Results:
Significant differences in terms of CVS positivity have been found between MS and its mimics. Moreover, CVS is able to distinguish patients with radiologically isolated syndrome (RIS) from subjects with non-MS conditions. Furthermore, some of the analysed studies have reported a promising performance of CVS rules in MS diagnosis.
Conclusions:
The results of the reviewed studies are undoubtedly encouraging, reinforcing CVS's role as a valuable tool in multiple sclerosis management.
Insights
The central vein sign (CVS) is a valuable neuroimaging marker that aids in diagnosing multiple sclerosis (MS) and differentiating it from similar conditions. This review confirms its utility in MS management.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple sclerosis (MS) is an inflammatory central nervous system (CNS) disease characterized by demyelination.
- Current MS diagnostic criteria require proof of lesion dissemination in time and space.
- Diagnostic ambiguities can arise in certain MS presentations.
Purpose of the Study:
- To systematically assess the utility of the central vein sign (CVS) in multiple sclerosis (MS) management.
- To evaluate CVS as a diagnostic and differentiating imaging marker for MS.
- To review evidence supporting the integration of CVS into MS diagnostic criteria.
Main Methods:
- Systematic review conducted following PRISMA 2020 guidelines.
- Searched PubMed and Embase databases for relevant studies.
- Included 48 recent studies for detailed analysis.
Main Results:
- Central vein sign (CVS) positivity significantly differs between MS and its mimics.
- CVS can distinguish radiologically isolated syndrome (RIS) from non-MS conditions.
- Proposed CVS rules show promising performance in MS diagnosis.
Conclusions:
- The central vein sign (CVS) is an encouraging and valuable tool in multiple sclerosis (MS) management.
- CVS reinforces the role of neuroimaging in improving MS diagnosis and differentiation.
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