title: Patterns of chronic venous insufficiency in the dural sinuses and extracranial draining veins and their relationship with white matter hyperintensities for patients with Parkinson's disease.
abstract: BACKGROUND
  Idiopathic Parkinson's disease (IPD) remains one of those neurodegenerative diseases for which the cause remains unknown. Many clinically diagnosed cases of IPD are associated with cerebrovascular disease and white matter hyperintensities (WMHs). The purpose of this study was to investigate the presence of transverse sinus and extracranial venous abnormalities in IPD patients and their relationship with brain WMHs.
  
  
  METHODS
  Twenty-three IPD patients and 23 age-matched normal controls were recruited in this study. They had conventional neurologic magnetic resonance structural and angiographic scans and, for blood flow, quantification of the extracranial vessels. Venous structures were evaluated with two-dimensional time of flight; flow was evaluated with two-dimensional phase contrast; and WMH volume was quantified with T2-weighted fluid-attenuated inversion recovery. The IPD and normal subjects were classified by both the magnetic resonance time-of-flight and phase contrast images into four categories: (1) complete or local missing transverse sinus and internal jugular veins on the time-of-flight images; (2) low flow in the transverse sinus and stenotic internal jugular veins; (3) reduced flow in the internal jugular veins; and (4) normal flow and no stenosis.
  
  
  RESULTS
  Broken into the four categories with categories 1 to 3 combined, a significant difference in the distribution of the IPD patients and normal controls (χ(2) = 7.7; P < .01) was observed. Venous abnormalities (categories 1, 2, and 3) were seen in 57% of IPD subjects and in only 30% of controls. In IPD subjects, category type correlated with both flow abnormalities and WMHs.
  
  
  CONCLUSIONS
  From this preliminary study, we conclude that a major fraction of IPD patients appear to have abnormal venous anatomy and flow on the left side of the brain and neck and that the flow abnormalities appear to correlate with WMH volume. Studies with a larger sample size are still needed to confirm these findings.
authors.affiliation: Department of Biomedical Engineering, Wayne State University, Detroit, Mich.
authors.forename: Manju
authors.initials: M
authors.lastname: Liu
authors.affiliation: Department of Radiology, Union Hospital, Wuhan, China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Radiology, Union Hospital, Wuhan, China.
authors.forename: Yuhui
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Magnetic Resonance Innovations, Inc, Detroit, Mich.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhong
authors.affiliation: Department of Radiology, Tianjin First Central Hospital, Tianjin, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Xia
authors.affiliation: Magnetic Resonance Innovations, Inc, Detroit, Mich.
authors.forename: David
authors.initials: D
authors.lastname: Utriainen
authors.affiliation: Department of Neurology, Union Hospital, Wuhan, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Biomedical Engineering, Wayne State University, Detroit, Mich; Magnetic Resonance Innovations, Inc, Detroit, Mich; Magnetic Resonance Imaging Institute for Biomedical Research, Detroit, Mich; Department of Radiology, Wayne State University, Detroit, Mich. Electronic address: nmrimaging@aol.com.
authors.forename: E Mark
authors.initials: EM
authors.lastname: Haacke
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D002681:China; D002908:Chronic Disease; D003251:Constriction, Pathologic; D004388:Dura Mater / Q000098:blood supply*; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000503:physiopathology*; D056784:Leukoencephalopathies / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D054064:Transverse Sinuses / Q000503:physiopathology*; D014689:Venous Insufficiency / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D066127:White Matter / Q000473:pathology*