MS patients with low central vein sign frequency can be identified by FLAIR* MRi sequences

The CVS can distinguish MS from other diseases of brain white matter possible better explanation or mimickers of MS as migraine, small vessel disease, NMO spectrum disorder and brain involvement in systemic autoimmune diseases. The treshold of the CVS frequency that allows exclusion of MS has been thus far established at 50% (“50% rule”). Definite MS patients (diagnosed according to McDonald criteria) and MS patients with clinical laboratory and MRi markers of better explanation, but not fulfilling the diagnostic criteria of other diseases (MS-plus), were included. The patients received one MRi scan including one FLAIR and one T2* sequence, and were statyfied according to the 50% rule. The clinical course of the two patient cohorts was then evaluated. A group of MS-plus patients with low CVS frequency (fulfilling the 50% rule) can be identified by one conventional MRi scan. The natural history of the disease in this group seems more benign than in definite MS and in MS-plus not fulfilling the 50% rule, suggesting either that these patients have a benign MS form or that are not MS.