Periventricular venous density in multiple sclerosis is inversely associated with T2 lesion count: a 7 Tesla MRI study.
BACKGROUND
Damage to venules in multiple sclerosis was first described decades ago. Today, ultrahigh magnetic field strength T2*-weighted magnetic resonance imaging (MRI) techniques depict very small cerebral veins in vivo with great anatomical detail.


OBJECTIVE
We aimed to investigate alterations of periventricular small blood vessel appearance in relation to T2 lesion count and distribution in multiple sclerosis and clinically isolated syndrome in comparison with healthy control subjects at 7 Tesla MRI.


METHODS
We investigated 38 patients (including 16 with early multiple sclerosis and seven with clinically isolated syndrome) and 22 matched healthy controls at 7 Tesla. The protocol included T2*-weighted Fast Low Angle Shot, and T2-weighted Turbo Inversion Recovery Magnitude sequences. We quantified periventricular venous density by a novel region-of-interest-based algorithm, expressing the ratio of 'veins per region-of-interest' as well as of 'periventricular vascular area'.


RESULTS
Our study revealed significantly decreased venous density in multiple sclerosis patients compared with healthy controls. Venous alterations were already detectable in clinically isolated syndrome and early multiple sclerosis, although to a smaller extent. Venous density correlated inversely with periventricular and whole-brain T2 lesion count. Furthermore, we found no indication for cerebral venous congestion in multiple sclerosis.


CONCLUSIONS
High spatially resolving anatomical T2*-weighted MRI revealed vascular alterations in early stages of multiple sclerosis, presumably as a part of widespread haemodynamic and metabolic alterations.
NeuroCure Clinical Research Center, Charité - University Medicine Berlin, Germany.
Tim
T
Sinnecker
Ivan
I
Bozin
Jan
J
Dörr
Caspar F
CF
Pfueller
Lutz
L
Harms
Thoralf
T
Niendorf
Alexander U
AU
Brandt
Friedemann
F
Paul
Jens
J
Wuerfel
D000328:Adult; D000368:Aged; D002550:Cerebral Veins / Q000473:pathology*; D002552:Cerebral Ventricles / Q000098:blood supply / Q000473:pathology*; D003711:Demyelinating Diseases / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology* / Q000503:physiopathology; D012720:Severity of Illness Index; D055815:Young Adult