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- Title
Diagnostic performance of central vein sign for multiple sclerosis with a simplified three-lesion algorithm.
- Authors
Solomon, Andrew J.; Watts, Richard; Ontaneda, Daniel; Absinta, Martina; Sati, Pascal; Reich, Daniel S.
- Abstract
Background: Detection of a “central vein sign” (CVS) on FLAIR* magnetic resonance imaging (MRI) is highly specific and sensitive for multiple sclerosis (MS). We evaluated the specificity and sensitivity of simplified CVS algorithms for MS diagnosis. Methods: MRIs from 10 participants with MS without additional comorbidities for MRI white matter abnormalities; 10 with MS and additional comorbidities for white matter abnormalities; 10 with migraine, white matter abnormalities, and no additional comorbidities; and 10 who had previously been erroneously diagnosed with MS were evaluated. 3T MRI T2-FLAIR and T2*-weighted sequences were acquired to create FLAIR* images. Three MS physician reviewers, blinded to diagnosis, evaluated two different algorithms: (1) three lesions pre-selected on FLAIR were subsequently evaluated for CVS on FLAIR*(select3). (2) FLAIR* was evaluated for up to three lesions with CVS (select3*). Results: For select3, average specificity across reviewers for MS was 0.98 and sensitivity 0.52 and a correct prediction of diagnosis demonstrated kappa = 0.29. For select3*, specificity was 0.81, sensitivity was 0.83, and kappa was 0.31. Conclusion: A simplified determination of CVS in three white matter lesions on 3T FLAIR* MRI demonstrated good specificity and sensitivity and fair inter-rater reliability for a diagnosis of MS and with further study, may be a candidate for clinical application.
- Subjects
MULTIPLE sclerosis; ALGORITHMS; BRAIN imaging; MAGNETIC resonance imaging; WHITE matter (Nerve tissue)
- Publication
Multiple Sclerosis Journal, 2018, Vol 24, Issue 6, p750
- ISSN
1352-4585
- Publication type
Article
- DOI
10.1177/1352458517726383