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.
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...
Dietary Patterns and Nutritional Factors in Multiple Sclerosis: A Narrative Review
Research article from Europe PMC.
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.