Marcin Hartel MD, Presenter: Nothing to Disclose

Marian Simka MD, PhD, Abstract Co-Author: Speaker, SERVIER

Tomasz Ludyga MD, PhD, Abstract Co-Author: Nothing to Disclose

Marek Kazibudzki, Abstract Co-Author: Nothing to Disclose

Pawel Latacz, Abstract Co-Author: Nothing to Disclose

Marcin Swierad, Abstract Co-Author: Nothing to Disclose

Ewa Kluczewska, Abstract Co-Author: Nothing to Disclose

Magnetic resonance venography (MRV) is a common noninvasive test for the diagnosing of chronic cerebrospinal venous insufficiency, a unique vascular pathology associated with multiple sclerosis, which is comprised of stenoses and occlusions in extracranial veins draining the central nervous system. Theoretically, MRV has a potential for replacing other diagnostic methods, since this examination can be combined with structural and functional imaging of the brain and cerebral vessels. Yet, at the moment no widely accepted and reliable MRV protocol for the assessment of CCSVI exists and therefore such protocols should be elaborated.

We performed MRV of internal jugular veins (IJV) in 100 multiple sclerosis patients using GE 1.5T Signa HDx scanner. For the purpose of this study we used the following imaging protocols: coronal fast spin-echo T2-weighted sequences with fat saturation (T2 FatSat) and axial two-dimensional time-of-flight (2D TOF). These two protocols evaluated primarily the characteristics of blood flow and were not focused on anatomy of blood vessels. The results of MRV were compared to catheter venography of internal jugular veins, with the later test serving purpose of the “gold standard”.

Parameters of sensitivity and specificity of our MRV protocols were as follows: right internal jugular vein - positive predictive value: 77%, negative predictive value: 30%, false positive rate: 73%, false negative rate: 21%, left internal jugular vein - positive predictive value: 83%, negative predictive value: 13%, false positive rate: 93%, false negative rate: 9%.

The results of our MRV protocols were better if compared to already known reliability of traditional MRV assessment utilizing gadolinium-enhanced imaging. Yet, they were far from perfection and it could be concluded that at the moment MRV cannot be used as a definitive test for CCSVI.

MRV reliability was better in left IJV. Perhaps, different settings should be applied for the assessment of right and left IJV, which may result in a higher sensitivity and specificity of this method.

Hartel, M, Simka, M, Ludyga, T, Kazibudzki, M, Latacz, P, Swierad, M, Kluczewska, E, Magnetic Resonance Venography for the Assessment of Impaired Outflow in the Internal Jugular Veins in the Patients with Chronic Cerebro-spinal Venous Insufficiency.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11014455.html