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    Decreased brain venous vasculature visibility on susceptibility-weighted imaging venography in patients with multiple sclerosis is related to chronic cerebrospinal venous insufficiency

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    Publication date
    2011
    Author
    Zivadinov, R.
    Poloni, G.U.
    Marr, K.
    Schirda, C.V.
    Magnano, C.R.
    Carl, E.
    Bergsland, N.
    Hojnacki, D.
    Kennedy, C.
    Beggs, Clive B.
    Dwyer, Michael G.
    Weinstock-Guttman, B.
    Show allShow less
    Keyword
    Adult
    Atrophy; Pathology
    Brain
    Case-control studies
    Cerebrovascular circulation; Physiology
    Chronic disease
    Female
    Humans
    Magnetic Resonance Imaging
    Male
    Middle aged
    Multiple Sclerosis
    Neuroimaging
    Phlebography
    Spinal cord; Blood supply
    Ultrasonography; Doppler; Transcranial
    Venous insufficiency
    REF 2014
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    Abstract
    BACKGROUND: The potential pathogenesis between the presence and severity of chronic cerebrospinal venous insufficiency (CCSVI) and its relation to clinical and imaging outcomes in brain parenchyma of multiple sclerosis (MS) patients has not yet been elucidated. The aim of the study was to investigate the relationship between CCSVI, and altered brain parenchyma venous vasculature visibility (VVV) on susceptibility-weighted imaging (SWI) in patients with MS and in sex- and age-matched healthy controls (HC). METHODS: 59 MS patients, 41 relapsing-remitting and 18 secondary-progressive, and 33 HC were imaged on a 3T GE scanner using pre- and post-contrast SWI venography. The presence and severity of CCSVI was determined using extra-cranial and trans-cranial Doppler criteria. Apparent total venous volume (ATVV), venous intracranial fraction (VIF) and average distance-from-vein (DFV) were calculated for various vein mean diameter categories: < .3 mm, .3-.6 mm, .6-.9 mm and > .9 mm. RESULTS: CCSVI criteria were fulfilled in 79.7% of MS patients and 18.2% of HC (p < .0001). Patients with MS showed decreased overall ATVV, ATVV of veins with a diameter < .3 mm, and increased DFV compared to HC (all p < .0001). Subjects diagnosed with CCSVI had significantly increased DFV (p < .0001), decreased overall ATVV and ATVV of veins with a diameter < .3 mm (p < .003) compared to subjects without CCSVI. The severity of CCSVI was significantly related to decreased VVV in MS (p < .0001) on pre- and post-contrast SWI, but not in HC. CONCLUSIONS: MS patients with higher number of venous stenoses, indicative of CCSVI severity, showed significantly decreased venous vasculature in the brain parenchyma. The pathogenesis of these findings has to be further investigated, but they suggest that reduced metabolism and morphological changes of venous vasculature may be taking place in patients with MS.
    URI
    http://hdl.handle.net/10454/6252
    Citation
    Zivadinov, R., Poloni, G. U., Marr, K., Schirda, C. V., Magnano, C. R., Carl, E., Bergsland, N., Hojnacki, D., Kennedy, C., Beggs, C. B., Dwyer, M. G., Weinstock-Guttman, B. (2011) Decreased brain venous vasculature visibility on susceptibility-weighted imaging venography in patients with multiple sclerosis is related to chronic cerebrospinal venous insufficiency. BMC Neurology, 11, 128.
    Link to publisher’s version
    http://dx.doi.org/10.1186/1471-2377-11-128
    Type
    Article
    Collections
    Engineering and Informatics Publications

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