Central vein sign in patients with inflammatory lesion of the upper cervical spinal cord on susceptibility weighted imaging at 3 tesla. Preliminary results

Abstract

Background The central vein sign (CVS) has been described in vivo in patients with MS but also in other inflammatory lesion of the brain such as neuromyelits optica spectrum disease and others. Recently, it has been used to differentiate patients with MS from other inflammatory lesions of the brain. Objective It was the goal of this study to demonstrate the feasibility of the depiction of the CVS in patients with inflammatory lesion of the upper cervical spinal cord using susceptibility weighted imaging (SWI). Methods Consecutive patients with inflammatory lesions of the upper cervical spinal cord were included. Patients were scanned using a 3 T Philips Ingenia CX. The presence of the CVS was assessed by two raters. Demographic and clinical parameters were compared between patients with and those without a CVS. Results 20 patients could be included. 15 patients had a diagnosis of MS. A CVS was present in 8 patients (40%). Agreement between the two raters was substantial (κ = 0.79). Time from first manifestation was significantly different (14 vs. 2 years, p = 0.021) between patients with CVS and without CVS. Conclusion The depiction of the CVS in the upper cervical spine is feasible. More research is necessary to evaluate these preliminary results and the value of the CVS in the spinal cord.