"The optimal sequence for identifying the central vein sign remains a subject of debate in the literature. While 3D-T2* EPI and susceptibility-weighted imaging are reported as the most accurate, the timing of their acquisition (pre- or post-contrast) also lacks standardisation, contributing to methodological variability. Indirect comparisons from meta-analysis suggest a slightly higher accuracy for 3D-T2* EPI, though studies with direct comparisons are few 13,14."
"On T2*-weighted images, the central vein..."
"However, the white matter lesion must not..."
"The optimal sequence for identifying the central vein sign remains a subject of debate in the literature. While 3D-T2* EPI and susceptibility-weighted imaging are reported as the most accurate, the timing of their acquisition (pre- or post-contrast) also lacks standardisation, contributing to methodological variability. Indirect comparisons from meta-analysis suggest a slightly higher accuracy for 3D-T2* EPI, though studies with direct comparisons are few 13,14."
"The optimal sequence for identifying the central vein sign remains a subject of debate in the literature. While 3D-T2* EPI and susceptibility-weighted imaging are reported as the most accurate, the timing of their acquisition (pre- or post-contrast) also lacks standardisation, contributing to methodological variability. Indirect comparisons from meta-analysis suggest a slightly higher accuracy for 3D-T2* EPI, though studies with direct comparisons are few 13,14."
Expected headings
"Interpretation"
"Percentage rules"
"Select 6 rule"
"The central vein sign is not pathognomonic but can be useful in helping differentiate multiple sclerosis from mimics, such as cerebral small vessel disease, neuromyelitis optica spectrum disorder, migraine, and inflammatory vasculopathies (e.g. systemic lupus erythematosus) 3,5-7,10-14."
"Calculating a percentage can be extremely time consuming, particularly in individuals with high lesion counts, and as such, alternative and more pragmatic approaches have been suggested, such as the select 6 rating methods 6, which is recommended in the 2024 revision of the McDonald criteria 14."
"≥6 lesions with typical morphology and central vein sign are present; or"