Department of Radiology, Stanford University, California, USA.
AJNR Am J Neuroradiol. 2011 Sep;32(8):1482-9. doi: 10.3174/ajnr.A2549. Epub 2011 Jul 14.
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.
MRV 已被提议作为一种可能的筛选方法，以识别可能在 MS 中起作用的慢性脑脊髓静脉功能不全。我们报告了比较 MS 患者的 MRV 和 CV 的初步经验，以评估静脉狭窄和侧支静脉引流。
对 39 例 MS 患者进行了对比剂动力学时间飞越和时间分辨成像的 MRV 和 CV。两名放射科医生独立、盲法地使用 4 分制对 IJ 静脉口径变化和非 IJ 侧支的存在和严重程度进行分级。
两种检查均常显示静脉异常，最常见的是 C1 水平和颈部下段 IJ 变平。两种方法之间具有中度至良好的一致性（κ=0.55；95%可信区间，0.45%-0.65%）。对于侧支，一致性仅为中等（κ=0.30；95%可信区间，0.09%-0.50%）。CV 分级为 IJ 节段轻度或更严重的患病率为 54%。如果 CV 被认为是标准，那么 MRV 的敏感性和特异性分别为 0.79（0.71-0.86）和 0.76（0.67-0.83）。狭窄程度与 CV 的侧支严重程度相关，但与 MRV 无关。
MS 患者在 MRV 和 CV 上均可见 IJ 口径变化，且在狭窄程度上两种方法之间的一致性高于侧支。如果 CV 被认为是标准，那么 MRV 的性能良好，但在 MRV 可用于筛查之前，可能需要进一步改进。
