title: Extracranial Venous abnormalities: A true pathological finding in patients with multiple sclerosis or an anatomical variant?
abstract: OBJECTIVE
  To evaluate the extracranial venous anatomy with contrast-enhanced MR venogram (CE-MRV) in patients without multiple sclerosis (MS), and assess the prevalence of various venous anomalies such as asymmetry and stenosis in this population.
  
  
  METHODS
  We prospectively recruited 100 patients without MS, aged 18-60 years, referred for contrast-enhanced MRI. They underwent additional CE-MRV from skull base to mediastinum on a 3T scanner. Exclusion criteria included prior neck radiation, neck surgery, neck/mediastinal masses or significant cardiac or pulmonary disease. Two neuroradiologists independently evaluated the studies to document asymmetry and stenosis in the jugular veins and prominence of collateral veins.
  
  
  RESULTS
  Asymmetry of internal jugular veins (IJVs) was found in 75 % of subjects. Both observers found stenosis in the IJVs with fair agreement. Most stenoses were located in the upper IJV segments. Asymmetrical vertebral veins and prominence of extracranial collateral veins, in particular the external jugular veins, was not uncommon.
  
  
  CONCLUSIONS
  It is common to have stenoses and asymmetry of the IJVs as well as prominence of the collateral veins of the neck in patients without MS. These findings are in contrast to prior reports suggesting collateral venous drainage is rare except in MS patients.
  
  
  CONCLUSIONS
  • The venous anatomy of the neck in patients without MS demonstrates multiple variants • Asymmetry and stenoses of the internal jugular veins are common • Collateral neck veins are not uncommon in patients without MS • These findings do not support the theory of chronic cerebrospinal venous insufficiency • MR venography is a useful imaging modality for assessing venous anatomy.
authors.affiliation: Department of Radiology, University of Ottawa, Ottawa, ON, K1Y 4E9, Canada. catorres@toh.on.ca.|Department of Medical Imaging, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada. catorres@toh.on.ca.|Ottawa Hospital Research Institute OHRI, Ottawa, ON, Canada. catorres@toh.on.ca.
authors.forename: Carlos
authors.initials: C
authors.lastname: Torres
authors.affiliation: Ottawa Hospital Research Institute OHRI, Ottawa, ON, Canada.|Department of Medicine, University of Ottawa, Ottawa, ON, Canada.|Division of Neurology, The Ottawa Hospital, Ottawa, ON, Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hogan
authors.affiliation: Department of Radiology, University of Ottawa, Ottawa, ON, K1Y 4E9, Canada.|Department of Medical Imaging, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada.
authors.forename: Satya
authors.initials: S
authors.lastname: Patro
authors.affiliation: Department of Radiology, University of Ottawa, Ottawa, ON, K1Y 4E9, Canada.|Department of Medical Imaging, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada.|Ottawa Hospital Research Institute OHRI, Ottawa, ON, Canada.
authors.forename: Santanu
authors.initials: S
authors.lastname: Chakraborty
authors.affiliation: Department of Radiology, University of Ottawa, Ottawa, ON, K1Y 4E9, Canada.|Department of Medical Imaging, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada.|Ottawa Hospital Research Institute OHRI, Ottawa, ON, Canada.
authors.forename: Thanh
authors.initials: T
authors.lastname: Nguyen
authors.affiliation: Department of Radiology, University of Ottawa, Ottawa, ON, K1Y 4E9, Canada.|Department of Medical Imaging, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada.|Ottawa Hospital Research Institute OHRI, Ottawa, ON, Canada.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Thornhill
authors.affiliation: Ottawa Hospital Research Institute OHRI, Ottawa, ON, Canada.|Department of Medicine, University of Ottawa, Ottawa, ON, Canada.|Division of Neurology, The Ottawa Hospital, Ottawa, ON, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Freedman
authors.affiliation: Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Canada.
authors.forename: Miguel
authors.initials: M
authors.lastname: Bussiere
authors.affiliation: Department of Radiology, University of Saskatchewan, Neuroradiologist, Saskatoon, Canada.
authors.forename: Hamid
authors.initials: H
authors.lastname: Dabirzadeh
authors.affiliation: Department of Medical Imaging, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada.
authors.forename: Betty Anne
authors.initials: BA
authors.lastname: Schwarz
authors.affiliation: Department of Medical Imaging, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Belanger
authors.affiliation: Department of Medical Imaging, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada.
authors.forename: Lysa
authors.initials: L
authors.lastname: Legault-Kingstone
authors.affiliation: Department of Radiology, Stony Brook School of Medicine, Stony Brook, NY, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Schweitzer
authors.affiliation: Department of Radiology, University of Ottawa, Ottawa, ON, K1Y 4E9, Canada.|Department of Medical Imaging, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada.|Ottawa Hospital Research Institute OHRI, Ottawa, ON, Canada.
authors.forename: Cheemun
authors.initials: C
authors.lastname: Lum
mesh_terms: D000293:Adolescent; D000328:Adult; D003097:Collateral Circulation; D003251:Constriction, Pathologic / Q000473:pathology; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000002:abnormalities* / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008482:Mediastinum / Q000098:blood supply; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000209:etiology / Q000473:pathology*; D009333:Neck / Q000098:blood supply; D015588:Observer Variation; D015995:Prevalence; D011446:Prospective Studies; D014680:Veins / Q000002:abnormalities / Q000473:pathology; D014689:Venous Insufficiency / Q000150:complications / Q000000981:diagnostic imaging; D055815:Young Adult
keywords: Contrast-enhanced MR venography; Internal jugular veins; Neck; Stenosis; Venous anatomy