title: Jugular Venous Flow Abnormalities in Multiple Sclerosis Patients Compared to Normal Controls.
abstract: BACKGROUND
  To determine if extracranial venous structural and flow abnormalities exist in patients with multiple sclerosis (MS).
  
  
  METHODS
  Magnetic resonance imaging was used to assess the anatomy and function of major veins in the neck in 138 MS patients and 67 healthy controls (HC). Time-of-flight MR angiography (MRA) was used to assess stenosis while 2-dimensional phase-contrast flow quantification was used to assess flow at the C2/C3 and C5/C6 levels. Venous flow was normalized to the total arterial flow. The MS patients were divided into stenotic (ST) and nonstenotic (NST) groups based on MRA assessment, and each group was compared to the HC group in anatomy and flow.
  
  
  RESULTS
  The MS group showed lower normalized internal jugular vein (IJV) blood flow (tIJV/tA) than the HC group (P < .001). In the MS group, 72 (52%) were classified as ST while 66 (48%) were NST. In the HC group, 11 (23%) were ST while 37 (77%) were NST. The ST-MS group had lower IJV flow than both HC and NST-MS groups.
  
  
  CONCLUSIONS
  After categorizing the MS population into two groups based upon anatomical stenosis, as determined from an absolute quantification of IJV cross section, clear differences in IJV flow between the ST-MS and HC samples became evident. Despite the unknown etiology of MS, abnormal venous flow was noted in a distinct group of MS patients compared to HC.
authors.affiliation: MRI Institute of Biomedical Research, Detroit, Michigan.
authors.forename: Sean K
authors.initials: SK
authors.lastname: Sethi
authors.affiliation: MRI Institute of Biomedical Research, Detroit, Michigan.
authors.forename: David T
authors.initials: DT
authors.lastname: Utriainen
authors.affiliation: Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Daugherty
authors.affiliation: Department of Radiology, Wayne State University, Detroit, Michigan.
authors.forename: Wei
authors.initials: W
authors.lastname: Feng
authors.affiliation: Synergy Health, Newport Beach, California.
authors.forename: J Joseph
authors.initials: JJ
authors.lastname: Hewett
authors.affiliation: Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan.
authors.forename: Naftali
authors.initials: N
authors.lastname: Raz
authors.affiliation: MRI Institute of Biomedical Research, Detroit, Michigan.|Department of Radiology, Wayne State University, Detroit, Michigan.
authors.forename: E Mark
authors.initials: EM
authors.lastname: Haacke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000503:physiopathology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000503:physiopathology*; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014652:Vascular Diseases / Q000209:etiology* / Q000503:physiopathology*; D055815:Young Adult
keywords: Venous flow; flow quantification; phase-contrast MRI; stenosis; vessel cross-sectional areas