Patients with multiple sclerosis with structural venous abnormalities on MR imaging exhibit an abnormal flow distribution of the internal jugular veins.
OBJECTIVE
To evaluate extracranial venous structural and flow characteristics in patients with multiple sclerosis (MS).


METHODS
Two hundred subjects with MS from two sites (n = 100 each) were evaluated with magnetic resonance (MR) imaging at 3 T. Contrast-enhanced time-resolved MR angiography and time-of-flight MR venography were used to assess vascular anatomy. Two-dimensional phase-contrast MR imaging was used to quantify blood flow. The MS population was divided into two groups: those with evident internal jugular vein (IJV) stenoses (stenotic group) and those without (nonstenotic group).


RESULTS
Of the 200 patients, 136 (68%) showed IJV structural abnormalities, including unilateral or bilateral stenoses at different levels in the neck (n = 101; 50.5%) and atresia (n = 35; 17.5%). The total IJV flow normalized to the total arterial flow of the stenotic group (56% ± 22) was significantly lower than that of the nonstenotic group (77% ± 14; P < .001). The arterial/venous flow mismatch in the stenotic group (12% ± 15) was significantly greater than that in the nonstenotic group (6% ± 12; P < .001). The ratio of subdominant venous flow rate (Fsd) to dominant venous flow rate (Fd) for the stenotic group (0.38 ± 0.27) was significantly lower than for the nonstenotic group (0.59 ± 0.23; P < .001). The majority of the stenotic group (67%) also had an Fsd of less than 3 mL/s, a Fd/Fsd ratio greater than 3:1, and/or a total IJV flow rate of less than 8 mL/s.


CONCLUSIONS
MR imaging provides a noninvasive means to separate stenotic from nonstenotic MS cases. The former group was more prevalent in the present MS population and carried significantly less flow in the IJVs than the latter.
Department of Biomedical Engineering, Wayne State University, Detroit, MI 48201, USA.
E Mark
EM
Haacke
Wei
W
Feng
David
D
Utriainen
Gabriela
G
Trifan
Zhen
Z
Wu
Zahid
Z
Latif
Yashwanth
Y
Katkuri
Joseph
J
Hewett
David
D
Hubbard
D000704:Analysis of Variance; D001783:Blood Flow Velocity / Q000502:physiology; D003251:Constriction, Pathologic; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007601:Jugular Veins / Q000503:physiopathology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D009103:Multiple Sclerosis / Q000503:physiopathology*; D009942:Organometallic Compounds
D003287:Contrast Media; D009942:Organometallic Compounds; D019786:Gadolinium DTPA; C112666:gadoversetamide