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Objective: To carry out a clinical and radiological assessment of the central vein sign (CVS) as a diagnostic marker for multiple sclerosis (MS) and other demyelinating and non-demyelinating diseases with focal brain damage, using clinical and laboratory examination data, as well as MRI., Material and Methods: The results of clinical and neuroradiological examination of 107 patients diagnosed with MS or with other diseases accompanied by focal brain damage according to MRI data were analyzed., Results: CVS is a sensitive but low-specific diagnostic marker of MS. According to our data, the sensitivity and specificity of 40 and 50% of the threshold of perivenular lesions in the diagnosis of MS are the same and amount to 100% and 39.4%, respectively. Neither the type of MS course, nor the severity of the course, nor the intake of DMT (disease modifying treatment), affect the proportion of foci with CVS. The spread of the proportion of foci with CVS in patients with MS was 60-100%. The proportion of foci with CVS is below 40 and 50% of the threshold in patients with demyelinating and non-demyelinating diseases (NMOSD, migraine, systemic lupus erythematosus, Susak disease, CLIPPERS), which allows for differential diagnosis with MS. The proportion of foci with CVS comparable to MS in patients with acute disseminated encephalomyelitis, small vessel disease, as well as in patients with radiologically isolated syndrome does not allow using this symptom in the differential diagnosis of these conditions., Conclusion: The use of CVS as a diagnostic marker of MS is possible only in combination with the already existing diagnostic criteria of MS.

This article reviews the literature concerning the possibility of using magnetic resonance imaging (MRI) with different field strengths to detect the central vein sign (CVS). CVS is a relatively new and promising symptom of multiple sclerosis (MS). This symptom is a parenchymal vein visualized with the help of special MRI modes, which is localized in the focus of demyelination. Studies show that CVS has a high sensitivity and specificity in the diagnosis of MS, allowing the differentiation from other demyelinating, vascular, systemic diseases. However, most studies in this direction have been done using different MR-sequences and on tomographs with different field strengths, so the purpose of this review is to summarize and compare the results of various studies, which may be of practical benefit to clinicians.