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Eur Radiol. 2017 Jan;27(1):239-246. Epub 2016 Mar 24.

Extracranial Venous abnormalities: A true pathological finding in patients with multiple sclerosis or an anatomical variant?

Author information

1
Department of Radiology, University of Ottawa, Ottawa, ON, K1Y 4E9, Canada. catorres@toh.on.ca.
2
Department of Medical Imaging, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada. catorres@toh.on.ca.
3
Ottawa Hospital Research Institute OHRI, Ottawa, ON, Canada. catorres@toh.on.ca.
4
Ottawa Hospital Research Institute OHRI, Ottawa, ON, Canada.
5
Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
6
Division of Neurology, The Ottawa Hospital, Ottawa, ON, Canada.
7
Department of Radiology, University of Ottawa, Ottawa, ON, K1Y 4E9, Canada.
8
Department of Medical Imaging, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada.
9
Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Canada.
10
Department of Radiology, University of Saskatchewan, Neuroradiologist, Saskatoon, Canada.
11
Department of Radiology, Stony Brook School of Medicine, Stony Brook, NY, USA.

Abstract

OBJECTIVE:

To evaluate the extracranial venous anatomy with contrast-enhanced MR venogram (CE-MRV) in patients without multiple sclerosis (MS), and assess the prevalence of various venous anomalies such as asymmetry and stenosis in this population.

MATERIALS AND METHODS:

We prospectively recruited 100 patients without MS, aged 18-60 years, referred for contrast-enhanced MRI. They underwent additional CE-MRV from skull base to mediastinum on a 3T scanner. Exclusion criteria included prior neck radiation, neck surgery, neck/mediastinal masses or significant cardiac or pulmonary disease. Two neuroradiologists independently evaluated the studies to document asymmetry and stenosis in the jugular veins and prominence of collateral veins.

RESULTS:

Asymmetry of internal jugular veins (IJVs) was found in 75 % of subjects. Both observers found stenosis in the IJVs with fair agreement. Most stenoses were located in the upper IJV segments. Asymmetrical vertebral veins and prominence of extracranial collateral veins, in particular the external jugular veins, was not uncommon.

CONCLUSION:

It is common to have stenoses and asymmetry of the IJVs as well as prominence of the collateral veins of the neck in patients without MS. These findings are in contrast to prior reports suggesting collateral venous drainage is rare except in MS patients.

KEY POINTS:

• The venous anatomy of the neck in patients without MS demonstrates multiple variants • Asymmetry and stenoses of the internal jugular veins are common • Collateral neck veins are not uncommon in patients without MS • These findings do not support the theory of chronic cerebrospinal venous insufficiency • MR venography is a useful imaging modality for assessing venous anatomy.

KEYWORDS:

Contrast-enhanced MR venography; Internal jugular veins; Neck; Stenosis; Venous anatomy

PMID:
27011374
DOI:
10.1007/s00330-016-4314-6
[Indexed for MEDLINE]

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