Tuesday, November 2, 2010 4:33 AM
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Ken Torbert
Abstract
- Correspondence to Dr Mike P Wattjes, MS Center Amsterdam, Department of Radiology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; m.wattjes@vumc.nl
- Received 12 July 2010
- Revised 27 August 2010
- Accepted 30 August 2010
- Published Online First 27 October 2010
Background Recent studies using colour-coded Doppler sonography showed that chronic impaired venous drainage from the central nervous
system is almost exclusively found
in multiple sclerosis (MS) patients. This study aimed to investigate the
intracranial and
extracranial venous anatomy and the
intracerebral venous flow profile in patients with MS and healthy
controls using magnetic
resonance venography (MRV).
Methods Twenty patients with definite MS and 20 age- and gender-matched healthy controls were examined. MR imaging was performed
on a whole-body 3T MR system
including both 3D phase-contrast and dynamic 3D contrast-enhanced MRV as
well as flow quantification
of the internal cerebral veins and
the straight sinus. Image analysis was performed by two experienced
interventional neuroradiologists
blinded to clinical data and
structural brain imaging. The intracranial and extracranial neck veins
were analysed for stenosis/occlusion
and alternative venous drainage
pattern.
Results A completely normal venous anatomy was observed in 10 MS patients and 12 controls. Anomalies of the venous system (venous
stenosis/occlusions) were found in
10 MS patients and eight healthy controls. An anomalous venous system in
combination with
associated alternative venous
drainage was observed in six MS patients and five healthy controls. Flow
quantification showed
no venous backflow in any MS patient
or control.
Conclusions Findings suggestive of anomalies of the cranial venous outflow anatomy were frequently observed in both MS patients and healthy
controls. Given the normal
intracranial venous flow quantification results, it is likely that these
findings reflect anatomical
variants of venous drainage rather
than clinically relevant venous outflow obstructions.
http://jnnp.bmj.com/content/early/2010/10/27/jnnp.2010.223479.abstract
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