Contributions
Abstract: P346
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Paediatric MS
Background: The diagnosis of paediatric-onset multiple sclerosis (POMS) has remained challenging and may thus delay treatment decisions. Recently, the central vein sign (CVS) was proposed as an additional diagnostic imaging biomarker in adult-onset multiple sclerosis (AOMS).
Objective: To evaluate the diagnostic value of the CVS in POMS.
Methods: We analysed 26 patients with POMS (median age at disease onset 14.8 years (range 7.2 - 17.1 years), median disease duration 12 months (range 4 - 73 months), median EDSS 1.0 (range 0 - 3.5)) for the existence of a central vein within lesions on highly resolving and co-registered 3D FLAIR and 3D susceptibility weighted imaging (SWI) at 3 Tesla.
Results: 232 lesions were analysed in total. A central vein was detectable within 96 (41%) lesions. All patients with POMS presented with at least one lesion containing a central vein, while 21 (81%) had at least two, and 17 (65%) had at least three lesions with a central vein. 17 (65%) patients with POMS had 40% or more lesions with a central vein.
Conclusion: The majority of all patients with POMS presented with cerebral white matter lesions containing a distinct central vein, suggesting a high potential of the CVS to improve POMS diagnosis in the future. CVS detection may be further improved by the selection of dedicated T2*-weighted sequences. Our findings are in line with previous reports in AOMS, and thus underline similarities between AOMS and POMS.
Disclosure: Tim Sinnecker has received travel support from Actelion and Roche, and speaker fees from Biogen. He is employee of the Medical Image Analysis Center AG in Basel. Eva Wuerfel and Nuria Cerda Fuertes have nothing to disclose. Dominik Meier is employee of the Medical Image Analysis Center AG in Basel. Tobias Derfuss received speaker fees, research support, travel support, and/or served on Advisory Boards or Steering Committees of Novartis Pharma, Merck, Biogen, Teva, Bayer-Schering, GeNeuro, Mitsubishi Pharma, MedDay, Roche, and Genzyme; he received research support from Biogen, Novartis, Swiss National Research Foundation, University of Basel, and Swiss MS Society. Jutta Gärtner has received in the last three years honoraria for lectures and consultancy fees from Bayer, Teva and Novartis. Jens Wuerfel is CEO of MIAC AG Basel, Switzerland. He served on scientific advisory boards of Actelion, Biogen, Genzyme-Sanofi, Novartis, and Roche. He is or was supported by grants of the EU (Horizon2020), German Federal Ministeries of Education and Research (BMBF) and of Economic Affairs and Energy (BMWI).
Abstract: P346
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Paediatric MS
Background: The diagnosis of paediatric-onset multiple sclerosis (POMS) has remained challenging and may thus delay treatment decisions. Recently, the central vein sign (CVS) was proposed as an additional diagnostic imaging biomarker in adult-onset multiple sclerosis (AOMS).
Objective: To evaluate the diagnostic value of the CVS in POMS.
Methods: We analysed 26 patients with POMS (median age at disease onset 14.8 years (range 7.2 - 17.1 years), median disease duration 12 months (range 4 - 73 months), median EDSS 1.0 (range 0 - 3.5)) for the existence of a central vein within lesions on highly resolving and co-registered 3D FLAIR and 3D susceptibility weighted imaging (SWI) at 3 Tesla.
Results: 232 lesions were analysed in total. A central vein was detectable within 96 (41%) lesions. All patients with POMS presented with at least one lesion containing a central vein, while 21 (81%) had at least two, and 17 (65%) had at least three lesions with a central vein. 17 (65%) patients with POMS had 40% or more lesions with a central vein.
Conclusion: The majority of all patients with POMS presented with cerebral white matter lesions containing a distinct central vein, suggesting a high potential of the CVS to improve POMS diagnosis in the future. CVS detection may be further improved by the selection of dedicated T2*-weighted sequences. Our findings are in line with previous reports in AOMS, and thus underline similarities between AOMS and POMS.
Disclosure: Tim Sinnecker has received travel support from Actelion and Roche, and speaker fees from Biogen. He is employee of the Medical Image Analysis Center AG in Basel. Eva Wuerfel and Nuria Cerda Fuertes have nothing to disclose. Dominik Meier is employee of the Medical Image Analysis Center AG in Basel. Tobias Derfuss received speaker fees, research support, travel support, and/or served on Advisory Boards or Steering Committees of Novartis Pharma, Merck, Biogen, Teva, Bayer-Schering, GeNeuro, Mitsubishi Pharma, MedDay, Roche, and Genzyme; he received research support from Biogen, Novartis, Swiss National Research Foundation, University of Basel, and Swiss MS Society. Jutta Gärtner has received in the last three years honoraria for lectures and consultancy fees from Bayer, Teva and Novartis. Jens Wuerfel is CEO of MIAC AG Basel, Switzerland. He served on scientific advisory boards of Actelion, Biogen, Genzyme-Sanofi, Novartis, and Roche. He is or was supported by grants of the EU (Horizon2020), German Federal Ministeries of Education and Research (BMBF) and of Economic Affairs and Energy (BMWI).