title: Magnetic resonance imaging signatures of vascular pathology in multiple sclerosis.
abstract: Venous vascular contributing factors to multiple sclerosis (MS) have been known for some time. Only recently has the scope of their potential role become more apparent with the theory of chronic cerebrospinal venous insufficiency (CCSVI). As research expands to further explore the role  of vascular pathology in the MS population, it is expedient to review the evidence from an imaging perspective. In this paper, we review the current state-of-the-art methods using magnetic resonance imaging (MRI) as applied to imaging MS patients and CCSVI. This includes evaluating imaging  signatures of vascular structure and flow as well as brain iron content. Upon review of the literature, we find that extracranial venous anomalies including stenosis, venous malformations, and collateralization of flow in the major veins of the neck have been observed to be prevalent in the  MS population. Abnormal flow has been reported in MS patients both in major vessels using phase-contrast flow quantification and in the brain using perfusion-weighted imaging. We discuss the role of quantitative flow imaging and its potential in assessing possible biomarkers for abnormal flow.  Finally, it has been suggested that the presence of high iron content may indirectly indicate progression of existing vascular pathology. To that end, we review the use of susceptibility-weighted imaging in monitoring iron in the thalamus, basal ganglia, and MS lesions.
authors.affiliation: Magnetic Resonance Innovations, Inc., Detroit, MI, USA.
authors.forename: David
authors.initials: D
authors.lastname: Utriainen
authors.forename: Gabriela
authors.initials: G
authors.lastname: Trifan
authors.forename: Sean
authors.initials: S
authors.lastname: Sethi
authors.forename: Saba
authors.initials: S
authors.lastname: Elias
authors.forename: Joseph
authors.initials: J
authors.lastname: Hewett
authors.forename: Wei
authors.initials: W
authors.lastname: Feng
authors.forename: E Mark
authors.initials: EM
authors.lastname: Haacke
mesh_terms: D001479:Basal Ganglia / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D001921:Brain / Q000098:blood supply*; D002560:Cerebrovascular Circulation / Q000502:physiology; D003251:Constriction, Pathologic / Q000150:complications / Q000473:pathology; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000706:statistics & numerical data; D009103:Multiple Sclerosis / Q000150:complications / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D059906:Neuroimaging / Q000379:methods; D013788:Thalamus / Q000378:metabolism; D014652:Vascular Diseases / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D054079:Vascular Malformations / Q000473:pathology; D014689:Venous Insufficiency / Q000150:complications / Q000473:pathology* / Q000503:physiopathology
chemical_list: D015415:Biomarkers; D007501:Iron