Article Figures & Data
Figures
- Fig 1.
Qualitative grading of IJV flattening in the upper neck in a healthy subject and a patient with MS. A–C, Representative images from a healthy subject demonstrating only mild flattening of the right internal jugular vein in the upper neck segment (A). D–F, Representative images from a patient with MS with more severe flattening. While there is no flattening in the midneck segment on the right or left side (E), there is mild and severe narrowing in the upper neck segment on the right and left sides (D), respectively, and severe and moderate narrowing in the lower neck segment on the right and left sides (F).
- Fig 2.
Qualitative grading scale for the presence and severity of neck collaterals in a healthy subject and a patient with MS (same subjects as in Fig 1). Select images from rotating MRV maximum-intensity-projection images are displayed (both source and rotating MIP images were available for review). A–D, Representative images from a healthy subject demonstrating the absence of significant collaterals (right side scored 0, left side scored 0). E–H, Representative images from a patient with MS with severe collaterals bilaterally, demonstrating prominent veins in the posterior paraspinal soft tissues of the upper neck with clear insertion of the vertebral artery venous plexus and deep cervical vein on the low IJV near the confluence (thick arrow). In addition, there are prominent upper thoracic paraspinal collateral veins (right side scored 3, left side scored 3) (thinner arrows.
- Fig 3.
Pooled and dichotomized analyses of IJV flattening scores (A) and collateral scores (B) in healthy subjects and patients with MS. The y-axis represents the number of segments (A) or sides (B) score at this level.
- Fig 4.
Relationship between summed (per side) collateral scores and summed (per side and per segment) IJV flattening scores. Each data point represents a single individual. There is a small but significant correlation between higher IJV flattening scores and higher collateral scores (ρ = 0.32; P = .005). In addition, patients with MS (circles) tend to cluster in the upper right compared with healthy subjects (squares), who cluster in the lower left, though there is significant overlap.
Tables
Reader agreement for axial TOF imaging to assess the presence and severity of flattening and TRICKS imaging to assess the presence and severity of collateralsa
Right Left Overall (P value) Flattening 0.75 0.73 0.74 (<.0001) Upper 0.71 0.68 Mid 0.41 0.55 Lower 0.79 0.77 Collaterals 0.57 0.59 0.58 (<.0001) ↵a Numbers presented are linear-weighted κ.
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