Presence of central veins and susceptibility weighted imaging for evaluating lesions in multiple sclerosis and leukoaraiosis.

PURPOSE: The process of demyelination in multiple sclerosis (MS) is reflected in lesions of the central nervous system (CNS), which are found in an abundance of different diseases and are frequently radiographically indistinguishable. Our aim was to determine whether the perivenous distribution of MS lesions identified on susceptibility weighted images (SWI) could be used as a specific radiographic sign for MS, and also to determine whether the visibility of the central vein (CV) is affected by the activity of MS lesions.

METHODS

We retrospectively examined 34 subjects with MS and 19 subjects with ischemic lesions, which underwent a 3T MRI investigation. According to FLAIR and T2-weighted sequences the lesions were categorized regarding location. The presence of CVs was determined on SWI. Gadolinium enhanced T1-weighted sequence was included for the evaluation of MS lesion activity.

RESULTS

A total load of 601 MS and 204 ischemic lesions was identified. We found significantly more lesions with CVs in the group with ischemic lesions compared to the group with MS lesions (p<0.001). Similarly, significantly more supratentorial peripheral ischemic lesions had CVs (p=0.011), whereas in supratentorial periventricular and intratentorial lesions we found no significant difference between the two groups (p=0.377 and p=0.615). Comparing the active and inactive MS lesions regarding CVs, we found no significant difference between the groups (p=0,472).

CONCLUSIONS

We can conclude that the presence of a CV is not a specific radiographic sign for MS. CVs can also be identified in lesions caused by various other diseases.