Lack of correlation between extracranial venous abnormalities and multiple sclerosis: a quantitative MRI study

Abstract

Sirio Cocozza and Antonietta Canna contributed equally to this work. Giuseppe Palma and Enrico Tedeschi share senior authorship.Objective: We aimed to evaluate the presence of venous stenosis and blood flow abnormalities in the neck vessels of patients with multiple sclerosis (MS), in respect to a group of age-and sex-matched healthy controls (HC), and their possible relations with clinical variables using a semi-automated quantitative MRI method. Methods: 45 patients with relapsing remitting MS and 40 HC were enrolled in this study. Flow rates and crosssectional areas of arterial and venous neck vessels were assessed by phase-contrast MRI at two different neck levels (C2-C3 and C6-C7), and differences between groups were evaluated with an unpaired t-test. Correlation between blood flow variables and clinical parameters was analyzed with Spearman's test. Results: A significant internal jugular vein (IJV) stenosis was found in 23/45 (51.1%) patients with MS and 18/40 (45.0%) HC. No differences were observed between patients with MS and HC for any of the flow measures obtained. No correlations were found between MRI measures and any of the tested clinical variables. Conclusion: No differences in the IJV area emerged at quantitative MRI evaluation, suggesting that stenosis of the extracranial veins is unrelated to MS. Furthermore, no flow differences in the neck vessels were found between patients with MS and HC in any of the tested flow measures, with no correlation with clinical variables. Our results confirm that the hypothesis of the presence of extracranial venous abnormalities in MS, both in terms of stenosis or flow measures, is not suitable. Advances in knowledge: Neck venous drainage abnormalities have been claimed to be associated with MS. Conversely, our quantitative MRI analysis seems to exclude that extracranial venous alterations are related to the disease.

Five-Year Longitudinal Study of Neck Vessel Cross-Sectional Area in Multiple Sclerosis

“…14, 16 On the other hand, some other studies reported absence of significant differences between MS and HC as to IJV CSA and flow rates. 15, 36 Our results at baseline are in line with the latter group of findings. However, the IJV CSA changes that we observed longitudinally in this study, in MS patients, may suggest a potential link between IJV CSA and the disease course.…”

Hemodynamics of cerebral veins analyzed by 2d and 4d flow mri and ultrasound in healthy volunteers and patients with multiple sclerosis

“…In addition, the anisotropic resolution of 2D PC voxels might theoretically have introduced a slightly imprecise velocity measurement with regard to curved vessel segments. In accordance with the approach of other groups, we chose straight vessel segments for the positioning of all vessel segments, minimizing the influence of this theoretical limitation.…”

“…Further studies examined the morphologic aspects of the venous system obtained by magnetic resonance imaging (MRI) or digital subtraction venography, which might be less susceptible to methodological bias, yet represent static observations. Several studies in MS patients have performed functional assessments of venous hemodynamics by means of MRI . Although the juxta‐ and subcortical white matter of the cerebral hemispheres' convexity is a frequent location of MS plaques and the superior sagittal sinus represents the main drainage, a systematic, concomitant hemodynamic assessment of both the superficial and deep intracranial venous system in MS, respecting the possible influx of collaterals into the superior sagittal sinus, is hitherto lacking.…”

Determinants of Deep Gray Matter Atrophy in Multiple Sclerosis: A Multimodal MRI Study

“…In this single-center observational study, 77 patients with MS (52 RRMS and 25 PMS according to the 2013 revised definition of MS phenotypes 20 ) and 41 healthy controls (HC) were enrolled from October 2013 to July 2015 in a neuroimaging study of neuroinflammatory disorders. 21,22 All patients with MS fulfilled the 2010 revised McDonald criteria, 23 while none of the HC presented with any condition that could affect the CNS. For all patients, the Expanded Disability Status Scale (EDSS) score was determined within 1 week from MR imaging by an experienced neurologist as an index of clinical disability, along with the record of disease duration (DD) and disease-modifying treatment (DMT) type (On-line Table 1).…”