title: Internal jugular vein blood flow in multiple sclerosis patients and matched controls.
abstract: The aim of the study was to investigate the Internal Jugular Veins dynamics using contrast enhanced ultrasonography in Multiple Sclerosis patients, clinically isolated syndrome patients and healthy controls. Contrast enhanced ultrasonography imaging of the Internal Jugular Vein was performed in fifty-eight patients with Multiple Sclerosis, seven clinically isolated syndrome patients and in thirteen healthy controls. Time-intensity curves were quantified using a semi-automated method and compared with clinical disease outcomes. Wash-out parameters were calculated and six Time-intensity curves shapes were created. Significantly reduction of wash-out rate in Internal Jugular Veins was detected in Multiple Sclerosis patients compared to healthy controls [22.2% (2.7%-65.9%) vs. 33.4% (16.2%-76.8%); P<0.005]. Internal Jugular Vein enhancement was heterogeneous in patients with Multiple Sclerosis and consisted of slow wash-out Time-intensity curves shapes, compared with almost only one type of Time-intensity curves shape in control subjects that correspond to fast enhancement and fast wash-out. The vein wash-in parameters were similar in Multiple Sclerosis group compared with controls. A significant correlation was found between Internal Jugular Vein wash-out and level of disability (R =  -0.402, p<0.05). Contrast enhanced ultrasonography of the Internal Jugular Vein with time intensity curve analysis revealed alterations of cerebral venous outflow in Multiple Sclerosis patients, however mechanisms that determine this condition remains unclear.
authors.affiliation: Institute of Biostructure and Bioimaging (IBB), Italian National Research Council (CNR), Naples, Italy; IRCCS, SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Mancini
authors.affiliation: Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University-School of Medicine, Naples, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Lanzillo
authors.affiliation: Institute of Biostructure and Bioimaging (IBB), Italian National Research Council (CNR), Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Liuzzi
authors.affiliation: Department of Advanced Biomedical Science, Federico II University-School of Medicine, Naples, Italy.
authors.forename: Orlando
authors.initials: O
authors.lastname: Di Donato
authors.affiliation: IRCCS, SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Ragucci
authors.affiliation: IRCCS, SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Monti
authors.affiliation: Department of Advanced Biomedical Science, Federico II University-School of Medicine, Naples, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Salvatore
authors.affiliation: Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University-School of Medicine, Naples, Italy.
authors.forename: Vincenzo Brescia
authors.initials: VB
authors.lastname: Morra
authors.affiliation: Department of Advanced Biomedical Science, Federico II University-School of Medicine, Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Salvatore
mesh_terms: D000328:Adult; D017668:Age of Onset; D016022:Case-Control Studies; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology*; D012039:Regional Blood Flow; D055815:Young Adult