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Updated: Aug 5, 2026
08:51
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
A Faster Way to Diagnose Multiple Sclerosis: The Central Vein Sign in Routine Clinical Practice
Christopher G S Gilmartin1,2, Thomas Paskin2, Margareta A Clarke1
1Mental Health and Clinical Neuroscience, School of Medicine, University of Nottingham, United Kingdom.
Neurology. Clinical Practice
|August 3, 2026
Summary
Implementing the central vein sign (CVS) in a fast-track pathway significantly accelerated multiple sclerosis (MS) diagnosis, eliminated the need for lumbar punctures (LPs), and reduced costs for patients.
Area of Science:
- Neurology
- Radiology
- Medical Diagnostics
Background:
- The central vein sign (CVS) is a diagnostic criterion for multiple sclerosis (MS) but is underutilized.
- Implementing CVS may reduce the need for invasive lumbar punctures (LPs).
Purpose of the Study:
- To evaluate the impact of a fast-track (FT) diagnostic pathway incorporating CVS analysis on MS diagnosis.
- To assess the efficiency, invasiveness, and cost-effectiveness of the FT pathway compared to the usual outpatient pathway.
Main Methods:
- Retrospective review of 59 consecutive patients diagnosed with MS between March 2024 and July 2025.
- Comparison of diagnostic timelines, LP rates, and costs between the FT pathway and the usual outpatient pathway.
Main Results:
- The FT pathway reduced the mean time to diagnosis by 83 days (2.9 vs 5.6 months, p=0.003).
- No patients in the FT pathway required an LP.
- The mean cost per patient was lower in the FT pathway (£707 vs £999).
Conclusions:
- Routine use of CVS within a structured diagnostic pathway accelerates MS diagnosis.
- This approach eliminates the need for LPs and reduces healthcare costs.
- Broader adoption of CVS can streamline the diagnostic workup for MS.
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