Assessment of central vein sign and paramagnetic rim lesions in pediatric multiple sclerosis

Ann Clin Transl Neurol. 2024 Nov;11(11):3031-3036. doi: 10.1002/acn3.52208. Epub 2024 Sep 18.

Abstract

The evaluation of white matter lesions (WMLs) showing the central vein sign (CVS) and paramagnetic rim lesions (PRLs) has been suggested to enhance the diagnostic work-up of adult multiple sclerosis (MS). We aimed to evaluate the fulfillment of different CVS criteria and the added value of PRLs in 22 pediatric MS patients. Eleven patients (50%) fulfilled the 40%-rule threshold. Nineteen (86%) patients had ≥3 CVS+ WMLs or ≥1 PRL, whereas 17 (77%) had ≥6 CVS+ WMLs or ≥1 PRL. A simplified CVS-based approach, with the combined evaluation of ≥1 PRL in patients with ≥6 CVS+ WMLs, may improve MS diagnosis in pediatric patients.

MeSH terms

  • Adolescent
  • Cerebral Veins / diagnostic imaging
  • Cerebral Veins / pathology
  • Child
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Multiple Sclerosis* / diagnosis
  • Multiple Sclerosis* / diagnostic imaging
  • Multiple Sclerosis* / pathology
  • White Matter* / diagnostic imaging
  • White Matter* / pathology