197 Diagnosing multiple sclerosis using the central vein sign: validating the proposed lesion assessment criteria [Abstract]

Clarke, Margareta, Allen, Christopher, Pai, Hari, Marshall, Madeleine, Tallantyre, Emma ORCID: https://orcid.org/0000-0002-3760-6634, Schmierer, Klaus, Dineen, Rob A., Morgan, Paul S., Tench, Christopher and Evangelou, Nikos 2025. 197 Diagnosing multiple sclerosis using the central vein sign: validating the proposed lesion assessment criteria [Abstract]. Journal of Neurology, Neurosurgery and Psychiatry 96 , A61. 10.1136/jnnp-2025-ABN.197

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Abstract

Introduction The central vein sign (CVS) is in the 2025 diagnostic criteria for MS. Current CVS guidelines preclude MRI assessment of certain lesions (small,confluent and/or containing multiple veins). No studies have reviewed the effects of these exclusion criteria on the diagnostic performance of the CVS. Aims Test the effects of including “ineligible” lesions on the diagnostic performance of the CVS in patients with possible MS. Methods 120 patients from two prospective studies of the CVS were included. Their eventual clinical diagnoses were compared to the diagnoses based on a positive CVS(>40% lesions with CVS and a positive simplified rule). The following CVS criteria were tested: original (excluding small, confluent lesions, and lesions with multiple veins), allowing inclusion of each “ineligible” lesion category, and all lesions. Results 90 individuals were diagnosed with MS and 30 with other conditions. 3,899 lesions were assessed. Original criteria had 87% diagnostic accuracy, 91% sensitivity and 73% specificity. Allowing assessment of all lesions had 83% accuracy, 81% sensitivity and 87% specificity whilst tripling the number of lesions eligible for assessment. A simplified “rule of 10” had 70% sensitivity and 70% specificity. Conclusion Including all lesions when assessing the CVS is simpler and maintains high diagnostic performance.

Item Type:	Short Communication
Date Type:	Publication
Status:	Published
Schools:	Schools > Medicine
Publisher:	BMJ Publishing Group
ISSN:	0022-3050
Last Modified:	20 Jan 2026 15:15
URI:	https://orca.cardiff.ac.uk/id/eprint/184074

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