mesЭкстремальная биомедицинаExtreme Medicine3033-89643033-8972Centre for Strategic Planning of the Federal Medical and Biological Agency10.47183/mes.2021.021mes-176Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙCLINICAL CASEИспользование симптома центральной вены для дифференциальной диагностики демиелинизирующих заболеваний центральной нервной системыCentral vein sign for differential diagnosis of demyelinating diseases of CNSБеловС. Е.BelovS. E.

ул. Островитянова, д. 1, 117437, г. Москва

Ostrovityanova, 1, 117437, Москва

ГубскийИ. Л.GubskyI. L.

ул. Островитянова, д. 1, 117437, г. Москва

Ostrovityanova, 1, 117437, Москва

ЛелюкВ. Г.LelyukV. G.

ул. Островитянова, д. 1, 117437, г. Москва

Ostrovityanova, 1, 117437, Москва

БойкоА. Н.BoykoA. N.

Алексей Николаевич Бойко

ул. Островитянова, д. 1, 117437, г. Москва

Alexey N. Boyko

Ostrovityanova, 1, 117437, Москва

boykoan13@gmail.comРоссийский национальный исследовательский медицинский университет имени Н. И. Пирогова; Федеральный центр мозга и нейротехнологий Федерального медико-биологического агентстваРоссияPirogov Russian National Research Medical University; Federal Center of Brain Research and Neurotechnologies of FMBARussian FederationФедеральный центр мозга и нейротехнологий Федерального медико-биологического агентстваРоссияFederal Center of Brain Research and Neurotechnologies of FMBARussian Federation202127102024233131136Copyright © Белов С.Е., Губский И.Л., Лелюк В.Г., Бойко А.Н., 20242024Белов С.Е., Губский И.Л., Лелюк В.Г., Бойко А.Н.Belov S.E., Gubsky I.L., Lelyuk V.G., Boyko A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.extrememedicine.ru/jour/article/view/176

Продолжается поиск биомаркеров, в том числе выявляемых с помощью методов нейровизуализации, обладающих высокой чувствительностью и специфичностью в диагностике РС. В качестве одного из них можно рассматривать симптом центральный вены, выявляемый при МРТ с использованием импульсной последовательности SWI и Т2*-взвешенных изображений. В то же время различаются данные по специфичности и чувствительности различных методов для выявления этого синдрома. Представлено два случая, близких по неврологическим нарушениям, требующих дифференциальной диагностики между РС и вторичной демиелинизацией на фоне системного заболевания (системной красной волчанки). Помимо рутинных МРТ-последовательностей, использовали SWI на томографе с индукцией магнитного поля 3 Тл. Подсчитывали очаги с симптомом центральной вены с определением доли перивенулярного поражения. В случае РС все рассматриваемые феномены локализовались перивенулярно, при вторичной демиелинизации на фоне системной красной волчанки доля очагов с симптомом центральной вены составила 16,7%. Последовательность SWI повышала информативность анализа.

The search for highly sensitive and highly specific biomarkers of MS, including neuroimaging biomarkers, continues. One of such biomarkers is the central vein sign detectable on SW and T2-weighted MR images. The sensitivity and specificity of methods used for central vein sign detection vary. This article describes two clinical cases of patients with similar neurological symptoms which required making differential diagnosis between multiple sclerosis and secondary demyelination in the presence of a systemic disorder (systemic lupus erythematosus). In addition to routine MR sequences, we used SWI generated by a 3T scanner. The lesions with the central vein sign were counted; the proportion of perivenular lesions was determined. In the multiple sclerosis case, all the lesions were perivenular; the proportion of lesions with the central vein sign in the patient with secondary demyelination in the presence of systemic lupus erythematosus was 16.7%. The use of SW images improved the informative value of the analysis.

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The authors declare that there are no conflicts of interest present.