title: MR venography in children and adolescents with multiple sclerosis does not show increased prevalence of extracranial veins anomalies.
abstract: BACKGROUND
  Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system that affects mainly young adults, but can occur also in children and adolescents. The pathogenesis of MS is still not fully understood and chronic cerebrospinal venous insufficiency (CCSVI) was suggested to be implicated in MS. Although there is no strong evidence to support this hypothesis, a considerable number of MS patients, including adolescents, have undergone endovascular treatment procedures. The aim of this study was the evaluate the prevalence of extracranial venous system anomalies in children and adolescents with multiple sclerosis in comparison to age-matched controls.
  
  
  METHODS
  Twenty-one children with clinically definite diagnosis of MS (mean age 13.8 years), and 19 age-matched controls (mean age 12.5 years) were investigated using 1.5 T scanner with coronal 3D contrast-enhanced coronal venography. The diameters of internal jugular veins (IJV) at both sides of the neck were estimated separately, from the level C1 to Th1.
  
  
  RESULTS
  Anomalies of the extracranial venous system were found in 10 MS patients (47.6%) and 13 controls (68.4%). Normal anatomy of extracranial veins was recognized in 11 MS patients (53%) and 6 controls (31%). Comparison of the measurement results for MS patients and the control group revealed that there are no significant statistical differences in cross-section areas for a given level.
  
  
  CONCLUSIONS
  We found no evidence to suggest that MS children and adolescents have more extracranial veins anomalies than healthy patients. Considering the risk of such treatment, endovascular interventions should be discourage.
authors.affiliation: Department of Diagnostic Imaging, The Children's Memorial Health Institute, Warsaw, Poland. Electronic address: e-jurkiewicz@o2.pl.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Jurkiewicz
authors.affiliation: Department of Neurology, The Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kotulska
authors.affiliation: Department of Diagnostic Imaging, The Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Nowak
authors.affiliation: Department of Diagnostic Imaging, The Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Chełstowska
authors.affiliation: Department of Diagnostic Imaging, The Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Armata
authors.affiliation: Department of Neurology, The Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Chmielewski
authors.affiliation: Department of Neurology, The Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Bilska
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000473:pathology*; D010690:Phlebography; D015995:Prevalence; D014680:Veins / Q000002:abnormalities*; D014689:Venous Insufficiency / Q000453:epidemiology
keywords: Children; Chronic cerebrospinal venous insufficiency; MR venography; Magnetic resonance imaging; Multiple sclerosis