European Radiology

, Volume 27, Issue 1, pp 239–246

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

  • Carlos Torres
  • Matthew Hogan
  • Satya Patro
  • Santanu Chakraborty
  • Thanh Nguyen
  • Rebecca Thornhill
  • Mark Freedman
  • Miguel Bussiere
  • Hamid Dabirzadeh
  • Betty Anne Schwarz
  • Stefanie Belanger
  • Lysa Legault-Kingstone
  • Mark Schweitzer
  • Cheemun Lum
Neuro

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

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

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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Carlos Torres
    • 1
    • 2
    • 3
  • Matthew Hogan
    • 3
    • 4
    • 5
  • Satya Patro
    • 1
    • 2
  • Santanu Chakraborty
    • 1
    • 2
    • 3
  • Thanh Nguyen
    • 1
    • 2
    • 3
  • Rebecca Thornhill
    • 1
    • 2
    • 3
  • Mark Freedman
    • 3
    • 4
    • 5
  • Miguel Bussiere
    • 6
  • Hamid Dabirzadeh
    • 7
  • Betty Anne Schwarz
    • 2
  • Stefanie Belanger
    • 2
  • Lysa Legault-Kingstone
    • 2
  • Mark Schweitzer
    • 8
  • Cheemun Lum
    • 1
    • 2
    • 3
  1. 1.Department of RadiologyUniversity of OttawaOttawaCanada
  2. 2.Department of Medical ImagingThe Ottawa HospitalOttawaCanada
  3. 3.Ottawa Hospital Research Institute OHRIOttawaCanada
  4. 4.Department of MedicineUniversity of OttawaOttawaCanada
  5. 5.Division of NeurologyThe Ottawa HospitalOttawaCanada
  6. 6.Department of Medicine, Division of NeurologyUniversity of AlbertaEdmontonCanada
  7. 7.Department of RadiologyUniversity of Saskatchewan, NeuroradiologistSaskatoonCanada
  8. 8.Department of RadiologyStony Brook School of MedicineStony BrookUSA

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