Stefanini M, Fabiano S, Garaci F, Marziali S, Meschini A, Cama V, Fornari M, Rossi S, Centonze D, Gandini R, Simonetti G, Floris R
From the Departments of Diagnostic Imaging (M.S., S.F., F.G., S.M., A.M., V.C., M.F., R.F., R.G., G.S.).
From the Departments of Diagnostic Imaging (M.S., S.F., F.G., S.M., A.M., V.C., M.F., R.F., R.G., G.S.)
AJNR Am J Neuroradiol. 2014 Jun;35(6):1174-9. doi: 10.3174/ajnr.A3816. Epub 2014 Feb 13.
Hypothetical correlation between chronic cerebrospinal venous insufficiency and MS has gained the attention of patients and the scientific community. Studies performed by echo-color Doppler ultrasonography have shown different results, and it is necessary to use more objective diagnostic techniques. The aim of our study was to evaluate the presence of stenoses affecting azygos veins and internal jugular veins by use of venography in patients with MS.
We recruited 2 groups of subjects who underwent venography: the study group included 29 patients with MS and the control group included 15 healthy volunteers. The ileo-lumbar plexus, the azygos, and the internal jugular veins were selectively catheterized. We considered any cross-sectional area reduction of the venous lumen >50% to be a significant stenosis. Furthermore, blood pressure was measured in the studied vessels at the stenotic internal jugular veins.
Selective venography showed at least 1 significant venous stenosis in 84% of subjects examined, without significant difference between the study group and the control group. Positive venography chronic cerebrospinal venous insufficiency patterns were found in 50% of all subjects examined, without any significant difference between the 2 groups. The multivariate logistic regression analysis failed to assess any significant association between the presence of a positive venography and MS condition. The difference between the median blood pressure of stenotic and nonstenotic internal jugular veins was not statistically significant (P = .46).
Our data exclude any direct correlation between chronic cerebrospinal venous insufficiency and MS because venous abnormalities were equally present in both groups.
慢性脑脊髓静脉功能不全与多发性硬化症之间的假设性关联已引起患者和科学界的关注。超声彩色多普勒检查所进行的研究显示出不同的结果,因此有必要使用更客观的诊断技术。我们研究的目的是通过静脉造影评估多发性硬化症患者奇静脉和颈内静脉狭窄的存在情况。
我们招募了两组接受静脉造影的受试者:研究组包括29例多发性硬化症患者,对照组包括15名健康志愿者。对髂腰丛、奇静脉和颈内静脉进行选择性插管。我们将静脉腔横截面积减少>50%视为显著狭窄。此外,在狭窄的颈内静脉处测量所研究血管的血压。
选择性静脉造影显示,在84%的受检受试者中至少存在1处显著静脉狭窄,但研究组和对照组之间无显著差异。在所有受检受试者中,50%发现了阳性静脉造影慢性脑脊髓静脉功能不全模式,两组之间无任何显著差异。多因素逻辑回归分析未能评估阳性静脉造影的存在与多发性硬化症病情之间的任何显著关联。狭窄和非狭窄颈内静脉的中位血压差异无统计学意义(P = 0.46)。
我们的数据排除了慢性脑脊髓静脉功能不全与多发性硬化症之间的任何直接关联,因为两组中均同样存在静脉异常。