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

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

Monica Margoni #  1   2   3 , Paolo Preziosa #  1   2   4 , Elisabetta Pagani  1 , Loredana Storelli  1 , Mor Gueye  1   2   4 , Lucia Moiola  2 , Massimo Filippi  1   2   3   4   5 , Maria A Rocca  1   2   4
Affiliations

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

Monica Margoni et al. Ann Clin Transl Neurol. 2024 Nov.

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.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
White matter lesions with central vein sign and paramagnetic rim in patients with pediatric multiple sclerosis. Axial fluid‐attenuated inversion recovery (FLAIR) sequence showing a confluent lesion (A) with multiple veins within its context on FLAIR* (B). Axial (C,E) FLAIR sequences showing brain T2‐hyperitense white matter lesions that, on FLAIR* (D,F) demonstrate a central vein sign (red triangles). In (F) the central vein sign is visible in the three plains (axial, sagittal, and coronal). Axial FLAIR sequence (G) showing a brain T2‐hyperitense white matter lesion that, on phase image (H), demonstrates a paramagnetic rim (blue triangle). See text for further details.
See this image and copyright information in PMC

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