Editing Multiple sclerosis (section)

===MRI===
Magnetic resonance imaging (MRI) of the brain and spine may show areas of demyelination (lesions or plaques). Gadolinium can be administered [[intravenous]]ly as a [[contrast agent]] to highlight active plaques, and by elimination, demonstrate the existence of historical lesions not associated with symptoms at the moment of the evaluation.<ref name="pmid11456302">{{cite journal | vauthors = McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, McFarland HF, Paty DW, Polman CH, Reingold SC, Sandberg-Wollheim M, Sibley W, Thompson A, van den Noort S, Weinshenker BY, Wolinsky JS | author1-link=W. Ian McDonald | author16-link=Jerry Wolinsky | title = Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis | journal = Annals of Neurology | volume = 50 | issue = 1 | pages = 121–7 | date = July 2001 | pmid = 11456302 | doi = 10.1002/ana.1032 | s2cid=13870943 | doi-access = free }}</ref><ref name="pmid18256986">{{cite journal | vauthors = Rashid W, Miller DH | title = Recent advances in neuroimaging of multiple sclerosis | journal = Seminars in Neurology | volume = 28 | issue = 1 | pages = 46–55 | date = February 2008 | pmid = 18256986 | doi = 10.1055/s-2007-1019127 | s2cid = 260317568 }}</ref>

Central vein signs (CVSs) have been proposed as a good indicator of MS in comparison with other conditions causing white lesions.<ref>{{cite journal | vauthors = Sinnecker T, Clarke MA, Meier D, Enzinger C, Calabrese M, De Stefano N, Pitiot A, Giorgio A, Schoonheim MM, Paul F, Pawlak MA, Schmidt R, Kappos L, Montalban X, Rovira À, Evangelou N, Wuerfel J | title = Evaluation of the Central Vein Sign as a Diagnostic Imaging Biomarker in Multiple Sclerosis | journal = JAMA Neurology | volume = 76 | issue = 12 | pages = 1446–1456 | date = December 2019 | pmid = 31424490 | pmc = 6704746 | doi = 10.1001/jamaneurol.2019.2478 | collaboration = MAGNIMS Study Group }}</ref><ref>{{cite journal |vauthors=Bernitsas E |title=The Central Vein Sign |journal=Practical Neurology |date=February 2020 |url=https://practicalneurology.com/articles/2020-feb/the-central-vein-sign |access-date=5 October 2021 |archive-date=5 October 2021 |archive-url=https://web.archive.org/web/20211005141611/https://practicalneurology.com/articles/2020-feb/the-central-vein-sign |url-status=live }}</ref><ref>{{cite journal | vauthors = Castellaro M, Tamanti A, Pisani AI, Pizzini FB, Crescenzo F, Calabrese M | title = The Use of the Central Vein Sign in the Diagnosis of Multiple Sclerosis: A Systematic Review and Meta-analysis | journal = Diagnostics | volume = 10 | issue = 12 | pages = 1025 | date = November 2020 | pmid = 33260401 | pmc = 7760678 | doi = 10.3390/diagnostics10121025 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Al-Zandi SH, Fayadh NA, Al-Waely NK |title=Central vein sign detected by SWI at 3 T MRI as a discriminator between multiple sclerosis and leukoaraiosis |journal=The Egyptian Journal of Radiology and Nuclear Medicine |date=1 March 2018 |volume=49 |issue=1 |pages=158–164 |doi=10.1016/j.ejrnm.2017.09.003 |doi-access=free }}</ref> One small study found fewer CVSs in older and hypertensive people.<ref>{{cite journal | vauthors = Guisset F, Lolli V, Bugli C, Perrotta G, Absil J, Dachy B, Pot C, Théaudin M, Pasi M, van Pesch V, Maggi P | title = The central vein sign in multiple sclerosis patients with vascular comorbidities | journal = Multiple Sclerosis | volume = 27 | issue = 7 | pages = 1057–1065 | date = June 2021 | pmid = 32749948 | doi = 10.1177/1352458520943785 | hdl-access = free | hdl = 2078.1/239849 }}</ref> Further research on CVS as a biomarker for MS is ongoing.<ref>{{cite news |vauthors=Chapman M |title=$7.2M NIH Grant Supports Study of MS Diagnostic Biomarker |url=https://multiplesclerosisnewstoday.com/news-posts/2020/06/16/cleveland-clinic-given-7-million-nih-grant-study-diagnostic-cvs-biomarker/ |agency=BioNews Services |date=16 June 2020 |access-date=5 October 2021 |archive-date=5 October 2021 |archive-url=https://web.archive.org/web/20211005173348/https://multiplesclerosisnewstoday.com/news-posts/2020/06/16/cleveland-clinic-given-7-million-nih-grant-study-diagnostic-cvs-biomarker/ |url-status=live }}</ref>

====In vivo vs postmortem lesion visibility in MRI scans====
Only postmortem MRI allows visualization of sub-millimetric lesions in cortical layers and in the cerebellar cortex.<ref>{{cite journal | vauthors = Weigel M, Dechent P, Galbusera R, Bahn E, Nair G, Lu PJ, Kappos L, Brück W, Stadelmann C, Granziera C | title = Imaging multiple sclerosis pathology at 160 μm isotropic resolution by human whole-brain ex vivo magnetic resonance imaging at 3 T | journal = Scientific Reports | volume = 11 | issue = 1 | pages = 15491 | date = July 2021 | pmid = 34326420 | pmc = 8322069 | doi = 10.1038/s41598-021-94891-1 }}</ref>