Use of MR Venography for Characterization of the Extracranial Venous System in Patients with Multiple Sclerosis and Healthy Control Subjects

Department of Neurology, School of Medicine and Biomedical Sciences, Buffalo Neuroimaging Analysis Center, State University of New York, 100 High St, Buffalo, NY 14203, USA.
Radiology (Impact Factor: 6.87). 02/2011; 258(2):562-70. DOI: 10.1148/radiol.10101387
Source: PubMed


To investigate the differences in the extracranial venous system in patients with multiple sclerosis (MS) and healthy control (HC) subjects by using magnetic resonance (MR) venography.
This HIPAA-compliant, prospective study was approved by the local institutional review board, and all participants gave informed consent. Fifty-seven patients, 41 (72%) with relapsing-remitting MS and 16 (28%) with secondary-progressive MS, and 21 HC subjects were imaged with a 3-T MR unit by using two-dimensional (2D) time-of-flight (TOF) and three-dimensional (3D) time-resolved imaging of contrast kinetics (TRICKS) sequences. In addition, six MS patients and six HC subjects underwent two sequential MR venographic examinations during 1 week to test image-reimage reproducibility. The morphologic features of internal jugular vein flow were classified as absent, pinpoint, flattened, crescentic, or ellipsoidal flow. Only absent and pinpoint flow were considered abnormal. The flow of the vertebral veins was classified as absent or present. The prominence of collateral neck veins and venous asymmetries between the left and right sides were assessed. Differences among groups were tested with a two-tailed Mann-Whitney two-sample rank-sum test.
No significant differences in morphologic features of flow in the internal jugular veins and vertebral veins were found between MS patients and HC subjects in any of the examined MR venographic parameters. No differences in asymmetry or prominence were found between MS patients and HC subjects. There was modest agreement (κ = 0.67) between 2D TOF and 3D TRICKS sequences. Image-reimage reproducibility showed modest agreement (κ = 0.66) for 2D TOF and low agreement for 3D TRICKS (κ = 0.33).
No significant differences in the extracranial venous systems between MS patients and HC subjects were detected by using MR venography. Standardized guidelines are needed to define parameters for the presence of venous anomalies.

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Available from: Chris Magnano, May 01, 2015
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    • "Besides these variations, the IJV shows physiological variation per side, the right IJV having a greater CSA in 68% in comparison to the left side [15], [16]. In our recent publicated study the median CSA measured at the level of the thyroid gland at both sides was found to be asymmetric (1.01±0.58 "
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    ABSTRACT: A new treatable venous disorder, chronic cerebrospinal venous insufficiency (CCSVI), has been proposed in patients with multiple sclerosis. The natural course of CCSVI has not been examined yet. This is crucial given the fact that surgical procedures are increasingly offered to MS patients to treat venous stenosis. To document the natural course of venous haemodynamics we performed extra- and transcranial echo colour Doppler (ECD) in 52 multiple sclerosis patients and 28 healthy controls (HC) and re-examined this group after a median period of 16 weeks. The reexamination was done being blinded to the initial findings and the patients did not undergo any intervention. The ECD examination at baseline showed CCSVI in 5 (9.6%) of the 52 multiple sclerosis patients and 0 HC (P = 0.26). At follow-up the diagnosis CCSVI could not be reconfirmed in 3 out of 5 patients at follow-up, while 2 new CCSVI-positive multiple sclerosis patients were detected. ECD examination shows a fluctuating natural course of the extracranial venous haemodynamics, which makes determination of CCSVI by ECD examination unreliable.
    Full-text · Article · Nov 2013 · PLoS ONE
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    • "In this study, we also assessed the presence and number of collateral veins, as previously described [22]. These included anterior and external jugular veins, facial veins, thyroid veins as well as deep cervical veins (Figure  2). "
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    Full-text · Article · Oct 2013 · BMC Neurology
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    • "Another study also reported no differences between 21 MS patients and 20 controls in relation to IJVs outflow and aqueductal cerebrospinal fluid flow using phase-contrast sequences and contrast-enhanced MRV [37]. Zivadinov et al. found no difference in morphological flow characteristics between MS patients and controls [44]. However, Dolic et al. found that progressive MS patients showed more morphological anomalies than those in relapsing stages of the disease [31]. "
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