MRI evaluation of the "central vein sign" in brain white matter lesions of multiple sclerosis and systemic autoimmune diseases

Specificity of the MRI diagnostic criteria for Multiple Sclerosis (MS) could be improved by the visualization of white matter (WM) lesions centered by a venule (“the central vein sign”), one of the most specific pathological characteristics of MS. In this study frequency of perivenular lesions (PVL) was evaluated in systemic autoimmune diseases with brain lesions with inflammatory micro-angiopathies (SAD) and compared with MS. The frequency of PVL was higher in MS than in SADs, including those fulfilling MS MRI criteria for dissemination in space, indicating that this marker can improve differential diagnosis between inflammatory demyelinating lesions due to MS and chronic ischemic lesions due to inflammatory small vessel diseases.