Characteristics of flow through the internal jugular veins at cervical C2/C3 and C5/C6 levels for multiple sclerosis patients using MR phase contrast imaging.

OBJECTIVES

To study blood flow characteristics through the internal jugular veins (IJVs) at the cervical levels C2/C3 and C5/C6 in the neck of multiple sclerosis (MS) patients.

METHODS

Magnetic resonance imaging at 3T was performed on 323 MS patients. Phase contrast imaging was used to quantify blood flow at both the C2/C3 and C5/C6 levels. Total IJV flow (tIJF) was normalized by total arterial flow (tAF). Contrast-enhanced time-resolved 3D MR arteriovenography and 2D time-of-flight MR venography were performed to assess IJV anatomy. Based on this assessment, the MS population was divided into non-stenotic (NST) and stenotic (ST) subjects.

RESULTS

Of all the patients, 100 (31%) belonged to the NST group and 223 (69%) belonged to the ST group. At the C2/C3 and C5/C6 levels, the normalized tIJF of the ST group was 56±26% and 51±23%, respectively. This was significantly lower than that of the NST group, 85±13% and 73±12% (P<0·001). Zero percent and 5% of the NST group had a normalized tIJF of less than 50% at the C2/C3 and C5/C6 levels, compared to 37% and 47% for the ST group. The tAF was smaller for the secondary and primary progressive MS patients than the relapsing remitting MS patients (P = 0·02 and 0·01, respectively), while the tIJF was similar among all MS types.

CONCLUSION

Total blood flow through the IJVs at both the C2/C3 and C5/C6 levels was reduced in the ST group compared to the NST group.