2026-03-16 九州大学
図. 新しいMRI指標の「中心静脈サイン」と「パラマグネティックリム病変」
＜関連情報＞
- https://www.kyushu-u.ac.jp/ja/researches/view/1437
- chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.kyushu-u.ac.jp/f/65073/26_0316_01.pdf
- https://journals.sagepub.com/doi/10.1177/13524585261420650
アジア人多発性硬化症患者における中心静脈徴候、常磁性辺縁病変、および皮質病変の診断性能 Diagnostic performance of central vein sign, paramagnetic rim lesion and cortical lesion in Asian patients with multiple sclerosis
Koji Shinoda , Ayano Matsuyoshi, […], and Noriko Isobe
Multiple Sclerosis Journal Published:February 26, 2026
DOI:https://doi.org/10.1177/13524585261420650
Abstract
Background:
The 2024 revised McDonald criteria for multiple sclerosis (MS) incorporate central vein sign (CVS) and paramagnetic rim lesion (PRL), but their utility in Asian patients remains unclear.
Objective:
To evaluate the performance of CVS, PRL and cortical lesion (CL) in distinguishing MS from neuromyelitis optica spectrum disorders (NMOSD) and myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) in Japanese patients.
Methods:
We conducted a cross-sectional study of 139 MS, 41 NMOSD and 12 MOGAD patients who underwent 3-Tesla magnetic resonance imaging (MRI), including susceptibility-weighted imaging.
Results:
At least one CVS was identified in 95% of MS, 59% of NMOSD and 42% of MOGAD, while PRL occurred in 63% of MS only. The CVS number (cutoff ⩾ 2) yielded 85.6% sensitivity and 75.5% specificity (area under the curve (AUC) 0.856), which improved in patients <50 (AUC 0.920) or <70 years (AUC 0.907), and when combined with PRL and CL (AUC 0.926). The Select 6 algorithm achieved 69.1% sensitivity and 98.1% specificity (AUC 0.836), which were comparable in patients <50 (AUC 0.879) or <70 years (AUC 0.839), but improved when combined with PRL and CL (AUC 0.925).
Conclusions:
Combining Select 6 or CVS number with PRL and CL, particularly in patients <50 or <70 years, provides robust diagnostic performance for MS in the Asian population.
