Epub: Zivadinov R, Poloni GU, Marr K, Schirda CV, Magnano CR, Carl E, Bergsland N, Hojnacki D, Kennedy C, Beggs CB, Dwyer MG, Weinstock-Guttman B. Decreased brain venous vasculature visibility on susceptibility-weighted imaging venography in patients with multiple sclerosis is related to chronic cerebrospinal venous insufficiency. BMC Neurol. 2011 ;11(1):128.
“Good News for CCSVIers? …A paper going against the tide!”
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 <.3mm, 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 <.3mm (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.