Differentiation by MRI between multiple sclerosis and MS-like syndromes with markers of "better explanation" of the diagnosis.

Multiple sclerosis (MS) white matter lesions are inflammatory-demyelinating (WM-ID) and perivenular whereas white matter lesions of primary small vessel disease migraine and systemic autoimmune diseases with neurological involvement are mainly ischemic and periarteriolar. In MS the “central vein (CV) sign" that can be visualized by T2* MRI sequences, is present in about 75% of the WM-ID lesions. In the other diseases the frequency is lower than 50%. In this study the CVsign was compared in definite MS and in MS patients with markers of “better explanation” of the diagnosis (MS-like), for evaluating differences in the pathogenic mechanisms. The CVsign can identify pathogenesis of most the MS–like patients.