CVS
Central Vein Sign (Perivenular Demyelination MRI Biomarker)
中心静脈サイン（CVS：静脈周囲性脱髄を示す特異的MRI所見）
1. Biological & Technical Mechanism
Histopathologically, Multiple Sclerosis plaques form around post-capillary venules ('Dawson's fingers') where autoreactive lymphocytes infiltrate across the blood-brain barrier. On high-resolution Susceptibility-Weighted Imaging (SWI), T2*-weighted EPI, or combined FLAIR* contrasts, deoxyhemoglobin within the central venule appears as a thin hypointense line or dot bisecting the hyperintense FLAIR lesion. Under the 'Select-6' or '40% / 50% CVS rule', a high proportion of CVS-positive lesions distinguishes MS with >90% specificity from cerebral small vessel disease, migraine, neuromyelitis optica (NMOSD), and MOGAD.
多発性硬化症の脱髄斑は、病理学的に毛細血管後細静脈を取り囲むように形成される（Dawson's fingers）という特徴を持ちます。高分解能T2*強調EPI画像やSWIと3D-FLAIR画像を融合した「FLAIR*画像」を撮像すると、高信号の白質病変の中央を細静脈（還元ヘモグロビンによる線状または点状の低信号）が貫く「中心静脈サイン（CVS）」が確認されます。評価対象病変のうちCVS陽性割合を算出する基準や、6個以上のCVS陽性病変を確認する「Select-6基準」により、脳小血管病、片頭痛、NMOSD、MOGAD等の類似白質病変とMSを90%以上の高い特異度で鑑別できます。
2. Open Science & Clinical Trial Significance
Adopted in the 2024 revisions to the McDonald Criteria, automated deep-learning detection of the Central Vein Sign (e.g., CVSnet on BIDS datasets) is a major research topic in neuroinformatics.
2024年改訂マクドナルド診断基準においてPRLとともに診断特異性を高める画像バイオマーカーとして位置づけられており、3D-FLAIRとT2*位相画像を組み合わせた深層学習自動検出モデルの開発に公開BIDSデータセットが広く活用されています。
Related Neuroscience Terms & Standards
Chronic white matter MS lesions bordered by a dense rim of iron-laden, proinflammatory activated microglia/macrophages, visible on T2* phase MRI, SWI, and QSM.
International consensus diagnostic framework integrating clinical attacks, MRI topography (Dissemination in Space/Time, optic nerve, CVS, PRLs), and CSF oligoclonal bands to diagnose MS.
MRI technique measuring anisotropic water diffusion along white matter tracts to quantify axonal integrity, demyelination, and structural connectomes.
Community ISO-aligned standard for organizing and describing neuroimaging (MRI, fMRI, dMRI, PET) and neurophysiological (EEG, MEG, iEEG) datasets.
Open Datasets & Research Publications Related to CVS
OpenNeuro BIDS Repository: 3T/7T 3D-FLAIR, MP2RAGE & Quantitative Susceptibility Mapping (QSM) of Paramagnetic Rim Lesions in Multiple Sclerosis
High-resolution structural MRI, T2*-weighted phase/QSM, and multi-shell diffusion tensor imaging (DTI) dataset with manual expert lesion masks for white matter lesions, paramagnetic rim lesions (PRLs), and central vein sign (CVS) assessment.
MSDA: COVID19 GDSI LocalDashboard - Federated MS Data Toolkit
Official open-source repository and tool for Multiple Sclerosis federated research and data harmonization under MS-DATA-ALLIANCE.
Global Data Sharing Initiative (GDSI): Containerized Federated Analysis Pipeline for MS Registries
International federated research initiative and containerized query framework allowing participating national MS registries to analyze disease-modifying therapy (DMT) safety, anti-CD20 outcomes, and PIRA progression without transferring identifiable patient data.
Multiple Sclerosis and Viruses: « Liaisons Dangereuses ».
Multiple sclerosis (MS) is a complex, multifactorial neurodegenerative disease with an aetiology that is still partially elusive. Several risk factors are associated with MS development including genetic predisposition and various environmental stressors; however, recently, viral infections have gained significant attention as a crucial environmental trigger. Despite the well-established link between Epstein-Barr virus (EBV) and MS susceptibility, a single-pathogen model fails to clearly characterise the molecular cascades driving the disease, suggesting that the transition from infection to autoimmune response involves more than one viral agent. In this review we examine the speculation that the interactions among different neurotropic viruses could serve a collective causative role in MS, which is under-researched in the literature at present. We summarise contradictory evidence on the role of different viral agents, including the Herpesviridae family (Human Cytomegalovirus, EBV, Herpes Simplex Viruses HSV-1 and HSV-2, and Varicella Zoster Virus), Paramyxoviridae family (Measles Virus and Rubella Virus), Influenza virus, SARS-CoV-2, and Human Endogenous Retroviruses (HERVs). Through interplay within shared molecular pathways, immune modulation, and activation of latent infections, these viruses may collectively influence the inflammatory and demyelinating processes that characterise MS. This review evaluates the etiological role of viral interplay in MS through the cumulative and interactive effects of these pathogens. The available epidemiological, immunological, and experimental data converge on the concept that viral co-exposures act synergistically to shape MS susceptibility in genetically predisposed individuals. Characterising these viral interactions presents a new research direction for the identification of novel biomarkers and the development of preventative strategies through the targeted control of viral networks.
CNM-Au8 Treatment Is Associated With Reduced Chronic Lesion Tissue Expansion in Relapsing-Remitting Multiple Sclerosis
BackgroundCNM-Au8, a catalytic nanocrystalline gold suspension, is proposed to support neuronal bioenergetics, but its effect on chronic lesion evolution in multiple sclerosis (MS) has not been reported. ObjectivesTo evaluate the effect of CNM-Au8 on chronic lesion tissue expansion (CLTE). Results...
MSDA Core Dataset (CDS): Standardized Global Real-World Data Harmonization Framework for Multiple Sclerosis
The MSDA Core Dataset (CDS) establishes a 44-variable international harmonization schema mapped to the OMOP Common Data Model, enabling privacy-preserving federated analytics across global Multiple Sclerosis registries.
Disclaimer: This encyclopedia entry is intended for academic neuroscience research and data science reference only, and does not constitute medical advice.