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European Radiology
Published in: European Radiology 5/2012

01-05-2012 | Head and Neck

Chronic cerebrospinal venous insufficiency: does ultrasound really distinguish multiple sclerosis subjects from healthy controls?

Authors: Fatih Kantarci, Sait Albayram, Nuri Onat Demirci, Asim Esenkaya, Derya Uluduz, Omer Uysal, Sabahattin Saip, Aksel Siva

Published in: European Radiology | Issue 5/2012

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Abstract

Objectives

To investigate the differences between multiple sclerosis (MS) and control subjects by using extracranial venous grey-scale, colour and spectral Doppler ultrasound.

Methods

The study included 62 subjects with a definitive diagnosis of MS and 54 control subjects. The cross sectional area (CSA), reflux during Valsalva manoeuvre, presence or absence of flow in the internal jugular vein (IJV) were assessed in upright and supine positions. The IJV and vertebral vein (VV) flow volumes (BFV) were also studied.

Results

Reflux in the IJV, an upright CSA greater than a supine CSA, and the presence or absence of flow in the IJV were not different between MS and control subjects. A CSA ≤ 0.3 cm2 was observed to be significantly higher in MS subjects. The IJV BFV was not significantly different between the groups; however, the VV BFV was significantly higher on the right side and lower on the left side in MS subjects.

Conclusions

Our use of ultrasound criteria reported in the literature for MS reveals differences between healthy controls and MS subjects that also overlap. Our experience suggests that Doppler ultrasound may not be clinically reliable and more studies are needed to clarify its role, if any.
Key Points
• Chronic cerebrospinal venous insufficiency is a controversial topic in multiple sclerosis.
• Ultrasound assessment of extracranial veins has yielded different results in the literature.
• These differences may be due to dependence on Doppler and selection bias.
• We found variations in vertebral vein flow in patients with multiple sclerosis.
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Metadata
Title
Chronic cerebrospinal venous insufficiency: does ultrasound really distinguish multiple sclerosis subjects from healthy controls?
Authors
Fatih Kantarci
Sait Albayram
Nuri Onat Demirci
Asim Esenkaya
Derya Uluduz
Omer Uysal
Sabahattin Saip
Aksel Siva
Publication date
01-05-2012
Publisher
Springer-Verlag
Published in
European Radiology / Issue 5/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2338-5

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