Cerebral blood perfusion changes in multiple sclerosis

Wuerfel, Jens; Paul, Friedemann; Zipp, Frauke

doi:10.1016/j.jns.2007.02.011

Cited by 55 publications

(32 citation statements)

References 54 publications

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“…Veins are typically considered capacitance vessels, and although they can constrict or dilate passively, their luminal size can also be modulated by a variety of mechanisms. For example, sympathetic activity can constrict veins, 26 and abnormal autonomic function can therefore result in venous dilatation in diseases where autonomic function is altered, such as MS. 27 In addition, the relationship between enlarged veins and impaired cerebral arterial blood flow, which has been described in several studies in MS, [28][29][30] may require consideration. It is worth noting that medullary veins in the brain can dilate in the setting of acute ischemia, 31 and cerebrovascular reactivity can be modulated by changes in the fraction of inspired carbon dioxide, 32 but whether such mechanisms play a role in MS is unknown.…”

Section: Ms Vs Non-ms Veinsmentioning

confidence: 99%

Multiple sclerosis shrinks intralesional, and enlarges extralesional, brain parenchymal veins

et al. 2013

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Objectives: Many multiple sclerosis (MS) lesions develop around small veins that are surrounded by perivenular inflammatory cells, but whether veins in the brains of people with MS are smaller or larger than similar veins in healthy volunteers or people with other neurologic diseases remains unknown. This question can be addressed by high-resolution, high-field-strength MRI.Methods: In a cross-sectional study performed on a standard 3 T clinical scanner, we acquired wholebrain T2*-weighted images with 0.55 mm isotropic voxels and reconstructed the courses of deep and superficial veins within the white matter. We compared the apparent diameters of intralesional and perilesional veins to those of extralesional MS veins, veins in healthy volunteers, and veins in individuals with other neurologic diseases.Results: We studied veins in 19 MS cases, 9 healthy volunteers, and 8 individuals with other neurologic diseases, analyzing a total of 349 veins. The mean diameter of intralesional veins (0.76 6 0.14 mm) was smaller than that of perilesional (1.18 6 0.13 mm; p , 0.001) and extralesional (1.13 6 0.14 mm; p , 0.001) veins, regardless of lesion size and location. Perilesional and extralesional MS veins were larger than non-MS veins (0.94 6 0.14 mm; p , 0.001), and intralesional MS veins were smaller (p , 0.001). Most multiple sclerosis (MS) lesions in the cerebral white matter expand outward from small, inflamed veins, 1,2 although demyelinated lesions not centered by small veins have been reported. Conclusions: 3The walls of veins in MS plaques are denser and heavily cellular, and perivenular fibrosis can be seen in the lesion center. 1 In chronic lesions, due to fibrosis and collagen deposition in the vein wall and perivascular space, venous caliber is significantly narrowed. 1,4 MRI venography at standard clinical field strength can demonstrate the perivenous distribution of MS lesions in vivo. 5 The ability to detect veins improves greatly as field strength increases, 6 because the degree to which deoxyhemoglobin in venous blood reduces signal intensity on T2*-weighted images becomes magnified.7 At 7 T, a central vessel can be identified in 87% of visible white matter lesions. 8An important open question is whether veins centering lesions are macroscopically different from veins outside lesions and from similar veins in healthy people and individuals with other neurologic diseases. One possibility is that the histopathologically observed perivenular cuffing and wall thickening induce macroscopic changes in intralesional veins. It is also possible, however, that such changes on MRI occur diffusely, affecting many if not all parenchymal veins in the MS brain; in this case, the changes would not be directly related to lesions, and their pathophysiologic significance would be less clear.

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Section: Ms Vs Non-ms Veinsmentioning

confidence: 99%

Multiple sclerosis shrinks intralesional, and enlarges extralesional, brain parenchymal veins

et al. 2013

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“…Focal perfusion abnormalities are typically observed in and around contusions, even before they become apparent on structural imaging (63)(64)(65). Perfusion, measured using Xenon-enhanced computed tomography (Xe-CT) (80)(81)(82)(83), CTP (63), and DSC-MRI (82)(83)(84), are altered in peri-contusional edematous regions, suggesting ongoing ischemic damage, and a role for perfusion imaging in prognosis (63,85). Focal brain perfusion abnormalities associated with extra-axial blood collections correlate with symptomatology.…”

Section: Conventional Mri Techniquesmentioning

confidence: 99%

Common data elements in radiologic imaging of traumatic brain injury

Haacke,

Duhaime,

Gean

et al. 2010

Magnetic Resonance Imaging

165

166

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Traumatic brain injury (TBI) has a poorly understood pathology. Patients suffer from a variety of physical and cognitive effects that worsen as the type of trauma worsens. Some noninvasive insights into the pathophysiology of TBI are possible using magnetic resonance imaging (MRI), computed tomography (CT), and many other forms of imaging as well. A recent workshop was convened to evaluate the common data elements (CDEs) that cut across the imaging field and given the charge to review the contributions of the various imaging modalities to TBI and to prepare an overview of the various clinical manifestations of TBI and their interpretation. Technical details regarding state-of-the-art protocols for both MRI and CT are also presented with the hope of guiding current and future research efforts as to what is possible in the field. Stress was also placed on the potential to create a database of CDEs as a means to best record information from a given patient from the reading of the images.

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“…This hypothesis is further supported by a quantitative MRI study that reported significantly increased venous oxygenation levels and decreased cerebral metabolic rates of oxygen in MS patients as compared with healthy controls [18]. Furthermore, vascular damage, a sequel of (perivascular) inflammation and gliosis [19] in MS, is associated with a globally reduced cerebral perfusion [20] and may thus contribute to diminished venous visibility on T2*w images [14,15]. Another possible cause of decreased oxygen uptake is the high level of nitric oxide (NO) due to repetitive vascular inflammation in MS competitively inhibiting mitochondrial uptake of oxygen in MS [18].…”

Section: Discussionmentioning

confidence: 75%

Neuromyelitis optica does not impact periventricular venous density versus healthy controls: a 7.0 Tesla MRI clinical study

Schumacher

Pache

Bellmann‐Strobl

et al. 2016

Magn Reson Mater Phy

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Object:To quantify the periventricular venous density in neuromyelitis optica spectrum disease (NMOSD) in comparison to multiple sclerosis (MS) and healthy control subjects. Materials and Methods:Sixteen NMOSD, sixteen MS and sixteen healthy control subjects (HC) underwent 7.0 Tesla (7T) MRI. The imaging protocol included T 2 * weighted (T2*w) fast low angle shot (FLASH) and fluid attenuated inversion recovery (FLAIR) sequences. The periventricular venous area (PVA) was manually determined by a blinded investigator in order to estimate the periventricular venous density in a region-of-interest based approach. Results:No significant differences in periventricular venous density indicated by PVA were detectable in NMOSD versus healthy controls (p=0.226). In contrast, PVA was significantly reduced in MS patients compared to HC (p=0.013). Conclusion:Unlike in MS, patients suffering from NMOSD did not show a reduced venous visibility.This finding may underscore primary and secondary pathophysiological differences between these two distinct diseases of the central nervous system. 5

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Cerebral blood perfusion changes in multiple sclerosis

Cited by 55 publications

References 54 publications

Multiple sclerosis shrinks intralesional, and enlarges extralesional, brain parenchymal veins

Multiple sclerosis shrinks intralesional, and enlarges extralesional, brain parenchymal veins

Common data elements in radiologic imaging of traumatic brain injury

Neuromyelitis optica does not impact periventricular venous density versus healthy controls: a 7.0 Tesla MRI clinical study

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