Abstract
MRV has been proposed as a possible screening method to identify chronic cerebrospinal venous insufficiency, which may play a role in MS. We report our initial experience comparing MRV and CV in MS patients to evaluate venous stenosis and collateral venous drainage. Time-of-flight and time-resolved imaging of contrast kinetics MRV and CV were performed in 39 MS patients. The presence and severity of both IJ vein caliber changes and non-IJ collaterals were graded by using a 4-point scale by 2 radiologists in an independent and blinded manner. Both studies frequently showed venous abnormalities, most commonly IJ flattening at the C1 level and in the lower neck. There was moderate-to-good agreement between the modalities (κ = 0.55; 95% CI, 0.45%-0.65%). For collaterals, agreement was only fair (κ = 0.30; 95% CI, 0.09%-0.50%). The prevalence of IJ segments graded mild or worse on CV was 54%. If CV was considered a standard, the sensitivity and specificity of MRV was 0.79 (0.71-0.86) and 0.76 (0.67-0.83), respectively. Degree of stenosis was related to the severity of collaterals for CV but not for MRV. IJ caliber changes were seen in characteristic locations on both MRV and CV in MS patients. Agreement between modalities was higher for stenosis than for collaterals. If CV is considered a standard, MRV performance is good but may require additional improvement before MRV can be used for screening.
Highlights
AND PURPOSE: MRV has been proposed as a possible screening method to identify chronic cerebrospinal venous insufficiency, which may play a role in MS
IJ caliber changes were seen in characteristic locations on both MRV and CV in MS patients
The concept of CCSVI as a possible etiology or potentiator of MS was inspired by the observation of reflux within an IJ vein during duplex sonography scanning of the neck in an MS patient.[1]
Summary
Time-of-flight and time-resolved imaging of contrast kinetics MRV and CV were performed in 39 MS patients. Coronal intracranial 2D-TOF MRV was performed with the following parameters: TR/TE, 40/5 ms; flip angle, 60°; section thickness, 1.5 mm skip 0; FOV, 22 cm; matrix, 256 ϫ 128; posterior saturation band. Contrastenhanced sagittal TRICKS MRV was performed during the bolus administration of gadopentetate dimeglumine, 0.1 mmol/kg, flow rate 3 mL/s, with the following parameters: TR/TE 6/1.3 ms; flip angle 30°; section thickness 1.7 mm skip 0; FOV 40 cm; matrix 416 ϫ 192. Time-resolved MIP images at 6.4 seconds intervals were created and used to determine the phase with the most venous opacification Using this phase, separate left and right sagittal MIP images were created to evaluate slow-flowing posterior paraspinal collateral venous flow. Considering CV as a standard, sensitivity and specificity were calculated for the dichotomized (ie, normal versus abnormal) scores
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
