title: Non-specific alterations of craniocervical venous drainage in multiple sclerosis revealed by cardiac-gated phase-contrast MRI.
abstract: OBJECTIVE
  There is an on-going controversy about venous drainage abnormalities in multiple sclerosis (MS). We applied cardiac-gated phase-contrast and venographic magnetic resonance (MR) techniques to compare venous drainage patterns in patients with MS, healthy controls, and subjects with migraine.
  
  
  METHODS
  A total of 27 patients with MS (21 female, age 12-59 years, mean disease duration 8.4 ± 8.5 years) and 27 age- and gender-matched healthy controls (21 female, age 12-60 years) were investigated with velocity-encoded cine-phase contrast MR sequences and a 2D time-of-flight MR venography of the cervicocranial region on a 3-T MRI. The data were compared with 26 patients with chronic migraine headaches (19 female, age 17-62 years), previously investigated with the same protocol. The degree of primary and secondary venous outflow in relation to the total cerebral blood flow (tCBF) was compared both quantitatively and qualitatively. Statistical analyses were performed using linear regression models.
  
  
  RESULTS
  Secondary venous outflow was significantly increased in patients with MS compared with healthy controls, both qualitatively (p < 0.001) and quantitatively (p < 0.013). The observed changes were independent of age and disease duration. Very similar alterations of venous drainage were detectable with the same approach in patients with migraine, without significant differences between MS and migraine patients (p = 0.65).
  
  
  CONCLUSIONS
  Our MRI-based study suggests that patients with MS have alterations of cerebral venous drainage similar to subjects with chronic migraine. These non-disease-specific changes seem to a secondary phenomenon rather than being of primary pathogenic importance.
authors.affiliation: Institute of Clinical Radiology, University of Munich - Grosshadern Campus, Ludwig-Maximilians-University Munich, Germany. birgit.ertl-wagner@med.uni-muenchen.de
authors.forename: Birgit
authors.initials: B
authors.lastname: Ertl-Wagner
authors.forename: Inga
authors.initials: I
authors.lastname: Koerte
authors.forename: Tania
authors.initials: T
authors.lastname: Kümpfel
authors.forename: Astrid
authors.initials: A
authors.lastname: Blaschek
authors.forename: Ruediger P
authors.initials: RP
authors.lastname: Laubender
authors.forename: Max
authors.initials: M
authors.lastname: Schick
authors.forename: Denise
authors.initials: D
authors.lastname: Steffinger
authors.forename: David
authors.initials: D
authors.lastname: Kaufmann
authors.forename: Florian
authors.initials: F
authors.lastname: Heinen
authors.forename: Maximilian
authors.initials: M
authors.lastname: Reiser
authors.forename: Noam
authors.initials: N
authors.lastname: Alperin
authors.forename: Reinhard
authors.initials: R
authors.lastname: Hohlfeld
mesh_terms: D000293:Adolescent; D000328:Adult; D002560:Cerebrovascular Circulation; D002648:Child; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology*; D010690:Phlebography / Q000379:methods; D055815:Young Adult