RT Journal Article
SR Electronic
T1 Intra- and Extraluminal Structural and Functional Venous Anomalies in Multiple Sclerosis, as Evidenced by 2 Noninvasive Imaging Techniques
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 16
OP 23
DO 10.3174/ajnr.A2877
VO 33
IS 1
A1 K. Dolic
A1 K. Marr
A1 V. Valnarov
A1 M.G. Dwyer
A1 E. Carl
A1 Y. Karmon
A1 C. Kennedy
A1 C. Brooks
A1 C. Kilanowski
A1 K. Hunt
A1 A.H. Siddiqui
A1 D. Hojnacki
A1 B. Weinstock-Guttman
A1 R. Zivadinov
YR 2012
UL http://www.ajnr.org/content/33/1/16.abstract
AB BACKGROUND AND PURPOSE: Chronic cerebrospinal venous insufficiency (CCSVI) is a vascular condition characterized by anomalies of the main extracranial cerebrospinal venous routes that interfere with normal venous outflow. Research into CCSVI will determine its sensitivity and specificity for a diagnosis of MS, its prevalence in MS patients, and its clinical, MRI, and genetic correlates. Our aim was to investigate the prevalence and number of intra- and extraluminal structural and functional extracranial venous abnormalities by using DS and MRV, in patients with MS and HCs. MATERIALS AND METHODS: One hundred fifty patients with MS, 104 (69.3%) with RR and 46 (30.7%) with a progressive MS course, and 63 age- and sex-matched HCs were scanned with 3T MR imaging by using TOF and TRICKS sequences (only patients with MS). All subjects underwent DS examination for intra- and extraluminal structural and functional abnormalities of the IJVs. Absent/pinpoint IJV flow morphology on MRV was considered an abnormal finding. Prominence of collateral extracranial veins was assessed with MRV. RESULTS: Patients with MS had a significantly higher number of functional (P < .0001), total (P = .001), and intraluminal (P = .005) structural IJV DS abnormalities than HCs. There was a trend for more patients with MS with extraluminal IJV DS abnormalities (P = .023). No significant differences were found on the MRV IJV flow morphology scale between patients with MS and HCs. Patients with progressive MS showed more extraluminal IJV DS abnormalities (P = .01) and more MRV flow abnormalities on TOF (P = .006) and TRICKS (P = .01) than patients with nonprogressive MS. There was a trend for a higher number of collateral veins in patients with MS than in HCs (P = .016). CONCLUSIONS: DS is more sensitive than MRV in detecting intraluminal structural and functional venous abnormalities in patients with MS compared with HCs, whereas MRV is more sensitive in showing collaterals. CCSVIchronic cerebrospinal venous insufficiencyCVcatheter venographyDSDoppler sonographyEDSSExpanded Disability Status ScaleGdgadoliniumHChealthy controlICCinterclass correlation coefficientIJVinternal jugular veinMRVMR venographyPPprimary-progressiveRRrelapsing-remittingSPsecondary-progressiveTOFtime-of-flightTRICKStime-resolved imaging of contrast kineticsVVvertebral veins