The central vein sign and paramagnetic rim lesions: biomarkers for an accurate differential diagnosis between multiple sclerosis and migraine.

Q3 Medicine

Radiologia Brasileira Pub Date : 2025-09-22 eCollection Date: 2025-01-01 DOI:10.1590/0100-3984.2025.0015

Viviana Regina Konzen, Alessandro Finkelsztejn, Raquel Prates Dos Santos, Adolfo Moraes de Souza, Matheus de Lima Ruffini, Renata Gomes Londero, Juliana Ávila Duarte

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Abstract

Objective: This study aimed to assess whether the evaluation of the central vein sign (CVS) and paramagnetic rim lesions (PRLs) using susceptibility-weighted magnetic resonance imaging (MRI) can distinguish multiple sclerosis (MS) from migraine.

Materials and methods: In this single-center observational study, we conducted a cross-sectional analysis of the CVS, determining the proportion of CVS-positive lesions per individual and absolute counts, using thresholds of 3 lesions (select3*) and 6 lesions (select6*), and of PRLs in participants with MS and in those with migraine, from 3.0-T MRI brain scans.

Results: The study included 20 participants with MS, 20 with migraine, and 20 included as healthy controls. The proportion of participants with CVS-positive lesions was higher in the MS group than in the migraine group (61.8% vs. 10.4%), and PRLs were observed exclusively in the MS group. The presence of at least one PRL and the select6* criterion demonstrated the highest diagnostic accuracy within the study sample.

Conclusion: The detection of the CVS and of a PRL on 3.0-T MRI scans may serve as a reliable biomarker to differentiate MS from migraine.

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中心静脉征象和顺磁边缘病变：多发性硬化症和偏头痛准确鉴别诊断的生物标志物。

目的：探讨敏感性加权磁共振成像（MRI）对中心静脉征象（CVS）和顺磁环病变（PRLs）的评价是否能区分多发性硬化症（MS）和偏头痛。材料和方法：在这项单中心观察性研究中，我们对CVS进行了横断面分析，确定每个人的CVS阳性病变比例和绝对计数，使用3个病变（select3*）和6个病变（select6*）的阈值，以及MS和偏头痛患者的prl，来自3.0 t MRI脑部扫描。结果：该研究包括20名MS患者，20名偏头痛患者和20名健康对照。MS组出现cvs阳性病变的比例高于偏头痛组（61.8%比10.4%），且prl仅在MS组中观察到。在研究样本中，存在至少一个PRL和select6*标准显示出最高的诊断准确性。结论：3.0 t MRI扫描中CVS和PRL的检测可作为鉴别MS与偏头痛的可靠生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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