Diagnostic accuracy of central vein sign on MRI in pediatric-onset multiple sclerosis: A systematic review and meta-analysis
Clinical Imaging, cilt.138, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 138
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.clinimag.2026.110910
- Dergi Adı: Clinical Imaging
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Aerospace Database, Compendex, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Health Research Premium Collection (ProQuest), Technology Collection (ProQuest)
- Anahtar Kelimeler: Central vein sign, Diagnostic accuracy, Magnetic resonance imaging, Meta-analysis, Pediatric multiple sclerosis, Systematic review
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet
Özet
Background Diagnosing multiple sclerosis (MS) in children is challenging due to overlap with other demyelinating disorders. The Central Vein Sign (CVS) is a promising MRI biomarker in adult MS, but its diagnostic role in pediatric-onset MS (POMS) remains unclear. This systematic review and meta-analysis provides the first focused evaluation of CVS accuracy in POMS diagnosis. Purpose To systematically evaluate prevalence and diagnostic accuracy of the central vein sign in POMS. Methods Followed PRISMA-DTA guidelines, a systematic search was performed on publicly available databases (PubMed, Embase, and Scopus) up to November 2024. Studies measuring the CVS accuracy on MRI in POMS patients were included. Meta-analysis using Open Meta-Analyst software calculated pooled proportions of CVS positivity per patient, per lesion number, the CVS mean positive rate, and lesion distribution patterns across different brain regions. Results Five studies ( n = 128; mean age 11.4–15.6 years, 34,4% male, disease duration 0.8–1.6 years) met inclusion criteria, of which four ( n = 118) were eligible for meta-analysis. The pooled proportion of CVS-positive patients was 0.643 (95% CI: 0.253 to 1.032, p < 0.001), and the pooled number of CVS-positive lesions was 13.851 (95% CI: 11.260 to 16.442, p = 0.829). The mean of the CVS-positive rate ratio was 0.531 (95% CI: 0.346 to 0.715, p < 0.001). Regional analysis revealed the highest CVS lesion burden in periventricular regions (mean = 4.62, 95% CI: 3.39–5.85, p = 0.249). Conclusion This systematic review and meta-analysis suggests that the central vein sign could be of diagnostic value in POMS, but pediatric-specific criteria are needed. Further prospective studies with standardized imaging are required to establish the role of CVS in differentiating POMS from other demyelinating disorders.