• Pascal Sati, Jiwon Oh, R Todd Constable, Nikos Evangelou, Charles R G Guttmann, Roland G Henry, Eric C Klawiter, Caterina Mainero, Luca Massacesi, Henry McFarland, Flavia Nelson, Daniel Ontaneda, Alexander Rauscher, William D Rooney, Amal P R Samaraweera, Russell T Shinohara, Raymond A Sobel, Andrew J Solomon, Constantina A Treaba, Jens Wuerfel, Robert Zivadinov, Nancy L Sicotte, Daniel Pelletier, Daniel S Reich, and NAIMS Cooperative.
• Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, NIH, 10 Center Drive MSC 1400, Building 10 Room 5C103, Bethesda, Maryland, USA.
• Nat Rev Neurol. 2016 Dec 1; 12 (12): 714-722.

AbstractOver the past few years, MRI has become an indispensable tool for diagnosing multiple sclerosis (MS). However, the current MRI criteria for MS diagnosis have imperfect sensitivity and specificity. The central vein sign (CVS) has recently been proposed as a novel MRI biomarker to improve the accuracy and speed of MS diagnosis. Evidence indicates that the presence of the CVS in individual lesions can accurately differentiate MS from other diseases that mimic this condition. However, the predictive value of the CVS for the development of clinical MS in patients with suspected demyelinating disease is still unknown. Moreover, the lack of standardization for the definition and imaging of the CVS currently limits its clinical implementation and validation. On the basis of a thorough review of the existing literature on the CVS and the consensus opinion of the members of the North American Imaging in Multiple Sclerosis (NAIMS) Cooperative, this article provides statements and recommendations aimed at helping radiologists and neurologists to better understand, refine, standardize and evaluate the CVS in the diagnosis of MS.

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