Magnetic resonance imaging signatures of vascular pathology in multiple sclerosis

  title={Magnetic resonance imaging signatures of vascular pathology in multiple sclerosis},
  author={David Utriainen and Gabriela Trifan and Sean K. Sethi and Saba N. Elias and Joseph Hewett and Wei Feng and Ewart Mark Haacke},
  journal={Neurological Research},
  pages={780 - 792}
Abstract Venous vascular contributing factors to multiple sclerosis (MS) have been known for some time. Only recently has the scope of their potential role become more apparent with the theory of chronic cerebrospinal venous insufficiency (CCSVI). As research expands to further explore the role of vascular pathology in the MS population, it is expedient to review the evidence from an imaging perspective. In this paper, we review the current state-of-the-art methods using magnetic resonance… 

The role of magnetic resonance imaging in assessing venous vascular abnormalities in the head and neck: a demonstration of cerebrospinal venous insufficiency in a subset of multiple sclerosis patients

Good agreement is shown that there is a high incidence of stenosis and structural venous abnormalities in the MS population and that this change results in reduced outflow of the IJVs and increased collateralization of venous return to the heart compared to healthy controls.

An Overview of Venous Abnormalities Related to the Development of Lesions in Multiple Sclerosis

It is come to the conclusion that a potential source of MS lesions is due to locally disrupted flow which in turn leads to remodeling of the medullary veins followed by endothelial damage with the subsequent escape of glial cells, cytokines, etc, which ultimately lead to the cascade of inflammatory and demyelinating events which ensue in the course of the disease.

Multimodal noninvasive and invasive imaging of extracranial venous abnormalities indicative of CCSVI: Results of the PREMiSe pilot study

This pilot study shows that both a non-invasive and invasive multimodal imaging diagnostic approach should be recommended to depict a range of extracranial venous anomalies indicative of CCSVI.

The role of noninvasive and invasive diagnostic imaging techniques for detection of extra-cranial venous system anomalies and developmental variants

The ability to define and reliably detect noninvasively these anomalies is an essential step toward establishing their incidence and prevalence and consensus guidelines and standardized imaging protocols are emerging.

Role of developmental venous anomalies in etiopathogenesis of demyelinating diseases

Developmental venous anomalies, which are generally regarded as innocent developmental anomalies, and neighboring signal increase were found significantly higher in the MS group compared with the control group, and the role of DVAs in the etiology of demyelinating lesions must be clarified through comprehensive future studies that use more advanced techniques.

Intra- and Extracranial MR Venography: Technical Notes, Clinical Application, and Imaging Development

It is believed that a short though exhaustive MRI scan of the whole intra- and extracranial venous drainage system can be valuable for a variety of pathologic conditions, given the possible venous implication in several neurological conditions.

Potential involvement of the extracranial venous system in central nervous system disorders and aging

The use of endovascular treatment for the correction of these extracranial venous abnormalities should be discouraged, until potential benefit is demonstrated in properly-designed, blinded, randomized and controlled clinical trials.

The Pathology of the Internal Jugular Vein in Multiple Sclerosis

The review summarizes studies which link the CCSVI pathophysiology to the complex MS pathogenesis, and particularly to the impact of restricted brain outflow on the cerebral spinal fluid dynamics and cerebral perfusion.



Using magnetic resonance imaging as a means to study chronic cerebral spinal venous insufficiency in multiple sclerosis patients.

MRI provides valuable information in the observation of potential CCSVI risk factors, and low total flow in the 2 dominant veins seemed to be the strongest indicator for risk of having stenoses in the multiple sclerosis population.

Dynamic susceptibility contrast perfusion MR imaging of multiple sclerosis lesions: characterizing hemodynamic impairment and inflammatory activity.

DSC-MRI measurements demonstrate potential for investigating hemodynamic abnormalities that are associated with inflammatory activity, lesion reactivity and vascular compromise in MS lesions and can be observed on quantitative color-coded maps even without blood-brain barrier breakdown.

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

MS patients with higher number of venous stenoses, indicative of CCSVI severity, showed significantly decreased venous vasculature in the brain parenchyma, suggesting that reduced metabolism and morphological changes of ven Mousculature may be taking place in patients with MS.

Hypoperfusion of brain parenchyma is associated with the severity of chronic cerebrospinal venous insufficiency in patients with multiple sclerosis: a cross-sectional preliminary report

This pilot study is the first to report a significant relationship between the severity of CCSVI and hypoperfusion in the brain parenchyma, and this findings should be confirmed in a larger cohort of MS patients to ensure that they generalize to the MS population as a whole.

Anomalous Venous Blood Flow and Iron Deposition in Multiple Sclerosis

  • A. V. SinghP. Zamboni
  • Medicine, Psychology
    Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism
  • 2009
The hypothesis that iron deposits in MS are a consequence of altered cerebral venous return and chronic insufficient venous drainage is supported and several recently published studies support the hypothesis that MS progresses along the venous vasculature.

MRI assessment of iron deposition in multiple sclerosis

Currently available magnetic resonance imaging techniques for the assessment of brain iron are presented, including relaxation time mapping, phase imaging, susceptibility‐weighted Imaging, susceptibility mapping, magnetic field correlation imaging, and direct saturation imaging.

Chronic cerebrospinal venous insufficiency in multiple sclerosis: a historical perspective.

A background to understand the development of the theory of CCSVI is provided and the relevant issues regarding its diagnosis and relationship to the pathogenesis of MS are frame.

Diminished visibility of cerebral venous vasculature in multiple sclerosis by susceptibility‐weighted imaging at 3.0 Tesla

Significant reduced visibility of periventricular white matter venous vasculature in patients as compared to control subjects is demonstrated, supporting the concept of a widespread hypometabolic MS disease process.

Sensitivity and specificity for screening of chronic cerebrospinal venous insufficiency using a multimodal non-invasive imaging approach in patients with multiple sclerosis.

In MS patients this diagnostic specificity increased to over 90% by combining internal jugular vein and vertebral vein abnormal DS andMRV findings, reflux in deep cerebral veins and MRV findings of >1 collateral veins.