TY - JOUR T1 - Comparison of MR and Contrast Venography of the Cervical Venous System in Multiple Sclerosis JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 1482 LP - 1489 DO - 10.3174/ajnr.A2549 VL - 32 IS - 8 AU - G. Zaharchuk AU - N.J. Fischbein AU - J. Rosenberg AU - R.J. Herfkens AU - M.D. Dake Y1 - 2011/09/01 UR - http://www.ajnr.org/content/32/8/1482.abstract N2 - BACKGROUND AND PURPOSE: MRV has been proposed as a possible screening method to identify chronic cerebrospinal venous insufficiency, which may play a role in MS. We report our initial experience comparing MRV and CV in MS patients to evaluate venous stenosis and collateral venous drainage. MATERIALS AND METHODS: Time-of-flight and time-resolved imaging of contrast kinetics MRV and CV were performed in 39 MS patients. The presence and severity of both IJ vein caliber changes and non-IJ collaterals were graded by using a 4-point scale by 2 radiologists in an independent and blinded manner. RESULTS: Both studies frequently showed venous abnormalities, most commonly IJ flattening at the C1 level and in the lower neck. There was moderate-to-good agreement between the modalities (κ = 0.55; 95% CI, 0.45%–0.65%). For collaterals, agreement was only fair (κ = 0.30; 95% CI, 0.09%–0.50%). The prevalence of IJ segments graded mild or worse on CV was 54%. If CV was considered a standard, the sensitivity and specificity of MRV was 0.79 (0.71–0.86) and 0.76 (0.67–0.83), respectively. Degree of stenosis was related to the severity of collaterals for CV but not for MRV. CONCLUSIONS: IJ caliber changes were seen in characteristic locations on both MRV and CV in MS patients. Agreement between modalities was higher for stenosis than for collaterals. If CV is considered a standard, MRV performance is good but may require additional improvement before MRV can be used for screening. CCSVIchronic cerebrospinal venous insufficiencyCIconfidence intervalCVcontrast venographyEDSSExpanded Disability Status ScaleIJinternal jugularMIPmaximum intensity projectionMRVMR venographyMSmultiple sclerosisncnot calculableNPVnegative predictive valuePPVpositive predictive valueTOFtime-of-flightTRICKStime-resolved imaging of contrast kinetics ER -