Cerebral vein changes in relapsing-remitting multiple sclerosis demonstrated by three-dimensional enhanced T2*-weighted angiography at 3.0 T
To investigate characteristics of the internal cerebral veins (ICVs) and their main tributaries and the deep medullary veins (DMVs) in patients with relapsing-remitting MS (RRMS) with enhanced T2*-weighted angiography imaging (ESWAN).
Fifty-three RRMS patients and 53 normal controls underwent conventional MRI and ESWAN. ESWAN venograms were created by performing minimum intensity projections of the phase images, and the resulting venograms were used to observe characteristic vascular changes, including scores of the ICVs and their main tributaries and manifestations of the DMVs. Two experienced radiologists analysed all data.
Patients showed decreased mean scores of the ICVs and their main tributaries compared with controls. The mean score in acute patients was higher than in stable patients. Furthermore, the DMVs diminished and shortened in 48 patients with longer disease duration, whereas the DMVs increased and elongated in 5 patients with shorter disease duration. The penetrating veins were well defined in 30 active lesions, whereas the veins were ill defined in 69 non-active lesions. Interestingly, well-defined penetrating veins were shown in 15 non-active lesions in the stable patients.
Enhanced T2*-weighted MR angiography can detect cerebral vein characteristics in relapsing-remitting MS patients, which may provide important information on the pathogenesis of MS.
• Enhanced T2*-weighted magnetic resonance angiography (ESWAN) provides new insights into multiple sclerosis
• ESWAN venograms clearly demonstrate the internal cerebral and deep medullary veins
• The internal cerebral veins exhibit abnormalities in patients with relapsing-remitting MS
• Deep medullary veins exhibit different manifestations in patients with different disease duration