Magnetic Resonance Imaging of Internal Jugular Veins in Multiple Sclerosis: Interobserver Agreement and Comparison with Doppler Ultrasound Examination
- Resource Type
- Authors
- Mauri Lepäntalo; Jussi Numminen; Sani Laukontaus; Markus Färkkilä; Maarit Venermo; Tomoko Kagayama; Sari Atula; Pentti J. Tienari; Johanna Pekkola
- Source
- Annals of vascular surgery. 42
- Subject
- ANOMALIES
MECHANISM
Male
DRAINAGE
FLOW
Thyroid Gland
Constriction, Pathologic
030204 cardiovascular system & hematology
0302 clinical medicine
Common carotid artery
Prospective Studies
Prospective cohort study
Observer Variation
medicine.diagnostic_test
CATHETER VENOGRAPHY
General Medicine
ASSOCIATION
Middle Aged
PREVALENCE
Female
Radiology
Cardiology and Cardiovascular Medicine
Blood Flow Velocity
Adult
medicine.medical_specialty
Multiple Sclerosis
HEALTHY CONTROLS
Transit time
DIAGNOSIS
03 medical and health sciences
Young Adult
Predictive Value of Tests
medicine.artery
medicine
Humans
Internal jugular vein
business.industry
Multiple sclerosis
Reproducibility of Results
Magnetic resonance imaging
Ultrasonography, Doppler
medicine.disease
3126 Surgery, anesthesiology, intensive care, radiology
Chronic cerebrospinal venous insufficiency
Regional Blood Flow
Case-Control Studies
Surgery
Doppler ultrasound
Jugular Veins
business
030217 neurology & neurosurgery
Magnetic Resonance Angiography
CEREBROSPINAL VENOUS INSUFFICIENCY
- Language
- ISSN
- 1615-5947
Background Doppler ultrasound (US) has been widely used to evaluate the cervical venous system of multiple sclerosis patients according to the hypothesis of chronic cerebrospinal venous insufficiency with contradictory results. Venous anatomy and pathology can be examined with less operator-dependent magnetic resonance imaging (MRI). Our aim is to assess the interobserver agreement in measuring internal jugular vein (IJV) cross-sectional area (CSA) in MR images and to explore the agreement between US and MRI in the detection of calibers of ≤0.3 cm 2 in the IJV CSA in the prospective study. Methods Thirty-seven multiple sclerosis patients underwent MRI of the cervical venous system. Two independent neuroradiologists measured the CSA of IJV at the mid-thyroid level. Furthermore, the time from contrast enhancement of common carotid arteries to that of each IJV (transit time in seconds) was assessed, and recorded whether IJV or the vertebral plexus visualized first during the contrast passage. US examination had been performed earlier. Results Interobserver agreement for assessing IJV CSA in MR images was substantial: the measurements differed >0.5 cm 2 between the examiners in only 5 IJVs (7%), Cohen's kappa 0.79. Transit times from common carotid artery to IJV varied between 5.1 and 14.1 sec. Fifteen patients had left-to-right asymmetry in the speed of IJV contrast filling. IJV CSA ≤ 0.3 cm 2 was found in 51 IJVs on the basis of US. Ten of these IJVs (19.6%) showed IJV CSA ≤ 0.3 cm 2 also in MRI. All IJVs defined as CSA ≤ 0.3 cm 2 in MRI met this caliber criterion also in US. Conclusions Interobserver agreement at the thyroid level of the IJV was good at MRI measurements. The US defines more IJVs as narrow (CSA ≤ 0.3 cm 2 ) than MRI. The US measurements for IJV CSA are not comparable with these methods. The US seems too sensitive in terms of finding venous stenosis.