Department of Neurology, School of Medicine and Biomedical Sciences, Buffalo Neuroimaging Analysis Center, State University of New York, 100 High St, Buffalo, NY 14203, USA.
Radiology. 2011 Feb;258(2):562-70. doi: 10.1148/radiol.10101387. Epub 2010 Dec 21.
To investigate the differences in the extracranial venous system in patients with multiple sclerosis (MS) and healthy control (HC) subjects by using magnetic resonance (MR) venography.
This HIPAA-compliant, prospective study was approved by the local institutional review board, and all participants gave informed consent. Fifty-seven patients, 41 (72%) with relapsing-remitting MS and 16 (28%) with secondary-progressive MS, and 21 HC subjects were imaged with a 3-T MR unit by using two-dimensional (2D) time-of-flight (TOF) and three-dimensional (3D) time-resolved imaging of contrast kinetics (TRICKS) sequences. In addition, six MS patients and six HC subjects underwent two sequential MR venographic examinations during 1 week to test image-reimage reproducibility. The morphologic features of internal jugular vein flow were classified as absent, pinpoint, flattened, crescentic, or ellipsoidal flow. Only absent and pinpoint flow were considered abnormal. The flow of the vertebral veins was classified as absent or present. The prominence of collateral neck veins and venous asymmetries between the left and right sides were assessed. Differences among groups were tested with a two-tailed Mann-Whitney two-sample rank-sum test.
No significant differences in morphologic features of flow in the internal jugular veins and vertebral veins were found between MS patients and HC subjects in any of the examined MR venographic parameters. No differences in asymmetry or prominence were found between MS patients and HC subjects. There was modest agreement (κ = 0.67) between 2D TOF and 3D TRICKS sequences. Image-reimage reproducibility showed modest agreement (κ = 0.66) for 2D TOF and low agreement for 3D TRICKS (κ = 0.33).
No significant differences in the extracranial venous systems between MS patients and HC subjects were detected by using MR venography. Standardized guidelines are needed to define parameters for the presence of venous anomalies.
通过磁共振（MR）静脉造影术研究多发性硬化症（MS）患者与健康对照（HC）受试者颅外静脉系统的差异。
本 HIPAA 合规性前瞻性研究经当地机构审查委员会批准，所有参与者均签署了知情同意书。使用 3T MR 设备对 57 例患者（41 例为复发缓解型 MS，16 例为继发进展型 MS）和 21 例 HC 受试者进行二维（2D）时间飞跃（TOF）和三维（3D）对比剂动力学时间分辨成像（TRICKS）序列的 MR 静脉造影。此外，6 例 MS 患者和 6 例 HC 受试者在 1 周内进行了两次连续的 MR 静脉造影检查，以测试图像重采的可重复性。颈内静脉血流形态特征分为无血流、点状血流、扁平血流、新月形血流或椭圆形血流。仅将无血流和点状血流视为异常。椎动脉血流分为无血流或有血流。评估颈侧支静脉的突出和左右侧静脉的不对称。使用双侧曼-惠特尼两样本秩和检验对组间差异进行检验。
在任何检查的 MR 静脉造影参数中，MS 患者与 HC 受试者之间颈内静脉和椎动脉的血流形态特征均无显著差异。MS 患者与 HC 受试者之间的不对称或突出也无差异。2D TOF 和 3D TRICKS 序列之间存在中等一致性（κ=0.67）。2D TOF 的图像重采可重复性中等一致（κ=0.66），而 3D TRICKS 的可重复性低（κ=0.33）。
通过 MR 静脉造影术未发现 MS 患者与 HC 受试者之间颅外静脉系统存在显著差异。需要制定标准化指南来定义静脉异常的存在参数。
