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Research ArticleEXTRACRANIAL VASCULAR
Open Access

Reproducibility of Cerebrospinal Venous Blood Flow and Vessel Anatomy with the Use of Phase Contrast–Vastly Undersampled Isotropic Projection Reconstruction and Contrast-Enhanced MRA

E.M. Schrauben, K.M. Johnson, J. Huston, A.M. del Rio, S.B. Reeder, A. Field and O. Wieben
American Journal of Neuroradiology November 2013, DOI: https://doi.org/10.3174/ajnr.A3779
E.M. Schrauben
From the Departments of Medical Physics (E.M.S., K.M.J., A.M.d.R., S.B.R., O.W.) and Radiology (J.H., S.B.R., A.F., O.W.), University of Wisconsin, Madison, Wisconsin.
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K.M. Johnson
From the Departments of Medical Physics (E.M.S., K.M.J., A.M.d.R., S.B.R., O.W.) and Radiology (J.H., S.B.R., A.F., O.W.), University of Wisconsin, Madison, Wisconsin.
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J. Huston
From the Departments of Medical Physics (E.M.S., K.M.J., A.M.d.R., S.B.R., O.W.) and Radiology (J.H., S.B.R., A.F., O.W.), University of Wisconsin, Madison, Wisconsin.
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A.M. del Rio
From the Departments of Medical Physics (E.M.S., K.M.J., A.M.d.R., S.B.R., O.W.) and Radiology (J.H., S.B.R., A.F., O.W.), University of Wisconsin, Madison, Wisconsin.
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S.B. Reeder
From the Departments of Medical Physics (E.M.S., K.M.J., A.M.d.R., S.B.R., O.W.) and Radiology (J.H., S.B.R., A.F., O.W.), University of Wisconsin, Madison, Wisconsin.
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A. Field
From the Departments of Medical Physics (E.M.S., K.M.J., A.M.d.R., S.B.R., O.W.) and Radiology (J.H., S.B.R., A.F., O.W.), University of Wisconsin, Madison, Wisconsin.
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O. Wieben
From the Departments of Medical Physics (E.M.S., K.M.J., A.M.d.R., S.B.R., O.W.) and Radiology (J.H., S.B.R., A.F., O.W.), University of Wisconsin, Madison, Wisconsin.
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Abstract

BACKGROUND AND PURPOSE: The chronic cerebrospinal venous insufficiency hypothesis raises interest in cerebrospinal venous blood flow imaging, which is more complex and less established than in arteries. For accurate assessment of venous flow in chronic cerebrospinal venous insufficiency diagnosis and research, we must account for physiologic changes in flow patterns. This study examines day-to-day flow variability in cerebrospinal veins by use of 4D MR flow and contrast-enhanced MRA under typical, uncontrolled conditions in healthy individuals.

MATERIALS AND METHODS: Ten healthy volunteers were scanned in a test-retest fashion by use of a 4D flow MR imaging technique and contrast-enhanced MRA. Flow parameters obtained from phase contrast-vastly undersampled isotropic projection reconstruction and contrast-enhanced MRA scoring measurements in the head, neck, and chest veins were analyzed for internal consistency and interscan reproducibility.

RESULTS: Internal consistency was satisfied at the torcular herophili, with an input-output difference of 2.2%. Percentages of variations in flow were 20.3%, internal jugular vein; 20.4%, azygos vein; 6.8%, transverse sinus; and 5.1%, common carotid artery. Retrograde flow was found in the lower internal jugular vein (4.8%) and azygos vein (7.2%). Contrast-enhanced MRA interscan κ values for the internal jugular vein (left: 0.474, right: 0.366) and azygos vein (−0.053) showed poor interscan agreement.

CONCLUSIONS: Phase contrast–vastly undersampled isotropic projection reconstruction blood flow measurements are reliable and highly reproducible in intracranial veins and in the common carotid artery but not in veins of the neck (internal jugular vein) and chest (azygos vein) because of normal physiologic variation. Retrograde flow normally may be observed in the lower internal jugular vein and azygos vein. Low interrater agreement in contrast-enhanced MRA scans was observed. These findings have important implications for imaging diagnosis and experimental research of chronic cerebrospinal venous insufficiency.

Abbreviations

CCSVI
chronic cerebrospinal venous insufficiency
IJV
internal jugular vein
AV
azygos vein
PC-VIPR
phase contrast–vastly undersampled isotropic projection reconstruction
COM
conservation of mass
LOA
limits of agreement
CE
contrast-enhanced
  • © 2014 American Society of Neuroradiology

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Reproducibility of Cerebrospinal Venous Blood Flow and Vessel Anatomy with the Use of Phase Contrast–Vastly Undersampled Isotropic Projection Reconstruction and Contrast-Enhanced MRA
E.M. Schrauben, K.M. Johnson, J. Huston, A.M. del Rio, S.B. Reeder, A. Field, O. Wieben
American Journal of Neuroradiology Nov 2013, DOI: 10.3174/ajnr.A3779

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Reproducibility of Cerebrospinal Venous Blood Flow and Vessel Anatomy with the Use of Phase Contrast–Vastly Undersampled Isotropic Projection Reconstruction and Contrast-Enhanced MRA
E.M. Schrauben, K.M. Johnson, J. Huston, A.M. del Rio, S.B. Reeder, A. Field, O. Wieben
American Journal of Neuroradiology Nov 2013, DOI: 10.3174/ajnr.A3779
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