Diagnostic performance of central vein sign and paramagnetic rim lesion integration for multiple sclerosis

Authors:
Publisher website
Google Scholar
Abstract
Background: The central vein sign (CVS) and the paramagnetic rim lesion (PRL) are neuroimaging biomarkers of multiple sclerosis (MS). Objectives: To determine the diagnostic performance of CVS and PRL integration in people presenting for initial diagnostic evaluation of MS. Methods: Adults with clinical/radiological suspicion of MS, aged 18–65, with CVS and PRL assessment from the CentrAl Vein Sign in MS (CAVS-MS) pilot were included. Diagnostic performance of CVS and PRL combinations was evaluated, with 2017 McDonald criteria as the reference standard. Results: Seventy-eight participants were included (71% female, 86% white, 37 with MS). The combination of ⩾1 CVS and ⩾1 PRL demonstrated sensitivity/specificity of 0.76 (95% CI, 0.59, 0.88) and 0.93 (95% CI, 0.80, 0.98). The combination of ⩾6 CVS and ⩾1 PRL demonstrated sensitivity/specificity of 0.57 (95% CI, 0.39, 0.73) and 1.00 (95% CI, 0.91, 1.00). In those with cerebrospinal fluid testing ( n = 46, 24 with MS), ⩾6 CVS and ⩾1 PRL diagnostic specificity was 1.00 (95% CI, 0.85, 1.00), similar to that of oligoclonal bands and dissemination in space by magnetic resonance imaging (0.82 [95% CI, 0.60, 0.95]). Discussion: Integrating CVS and PRL represents potentially advantageous MS diagnostic biomarkers, with increased specificity and without substantial reduction in sensitivity.
Funding Information
  • National Institute of Neurological Disorders and Stroke (R01NS112274)
  • National Institutes of Health (R01MH123550)
  • Race to Erase MS
  • National Institutes of Health

This publication has 31 references indexed in Scilit: