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AJNR - American Journal of Neuroradiology

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MR Venography of Multiple Sclerosis

I Leng Tan^,a, Ronald A. van Schijndel^a, Petra J. W. Pouwels^a, Marianne A. A. van Walderveen^a, Juergen R. Reichenbach^a, Radu A. Manoliu^a and Frederik Barkhof^a

^a From the Departments of Radiology (IL.T., M.A.A.v.W., R.A.M, F.B.) and Clinical Physics & Informatics (R.A.v.S., P.J.W.P.), University Hospital Vrije Universiteit, Amsterdam; and the Institute of Diagnostic and Interventional Radiology, Friedrich Schiller Universiteit, Jena, Germany (J.R.R.).

View larger version (114K): [in a new window]   FIG 1. A and B, Axial T2-weighted MR image (7000/112/2) (A) at the level of the lateral ventricles and corresponding contrast-enhanced MR venogram (67/50/1) (B). The inset in B is the minimum intensity projection image calculated over 7.5 mm of the boxed area. The form and orientation of the left periventricular MS lesion (wide arrow) corresponds to the course of the longitudinal caudate vein. The lesion at the posterior limb of the right internal capsule (thin arrow) corresponds to the course of a striate vein. Curved arrow indicates internal cerebral vein; open arrow, septal vein

View larger version (116K): [in a new window]   FIG 2. A and B, Axial T2-weighted MR image (7000/112/2) (A) at the level of the lateral ventricles and corresponding contrast-enhanced MR venogram (67/50/1) (B), with magnified image shown in boxed area. Periventricular lesions as well as a deep white matter lesion (straight arrow) and subcortical lesion (bent arrow) are demonstrated. The form and orientation of the lesions correspond to the course of their in-plane running central vein. The deep medullary vein running through the deep white matter lesion drains into the septal vein, and the caudate veins drain into the thalamostriate vein (curved arrow)

View larger version (115K): [in a new window]   FIG 3. A and B, Axial T2-weighted image (7000/112/2) (A) and corresponding contrast-enhanced MR venogram (67/50/1) (B) with magnified image shown in boxed area. The lesion at the left occipital horn (long wide arrow) is hypointense, with ring enhancement visible on the T1-weighted SE image (not shown). The MR venogram shows a vein with its course corresponding to the form of the lesion. Note the susceptibility artifacts in the frontal regions and the low intensity of the globus pallidus (open arrow), substantia nigra (short wide arrow), and red nucleus (thin arrow)