A number of recent clinical radiology studies support the central vessel sign (CVS) as a sensitive and specific means of differentiating MS white matter lesions (WML) from non-MS WML. However, these studies have employed varying practices for imaging veins and WMLs. This has led to an inconsistent radiological definition of CVS. Recently, the North American Imaging in Multiple Sclerosis publisheda set of guidelines, which provide grounds for derivation of a more robust radiological definition of CVS. Here we employ these guidelines, together with FLAIR and SWI at high field to arrive at a sensitive and specific radiological definition of CVS.