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MR venography of multiple sclerosis
I L Tan1, R A van Schijndel, P J Pouwels
1Department of Radiology, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Background And Purpose:
The distribution of multiple sclerosis (MS) lesions in the brain follows a specific pattern, with most lesions in the periventricular regions and in the deep white matter; histopathologic studies have shown a perivenous distribution. The aim of this study was to illustrate these distribution patterns in vivo using high-resolution MR venography.
Methods:
Seventeen MS patients underwent MR imaging at 1.5 T. Venographic studies were obtained with a 3D gradient-echo technique. MS lesions were identified on T2-weighted images, and their shape, orientation, and location were compared with the venous anatomy on the venograms.
Results:
The use of contrast material facilitated the visualization of small veins and increased the number of veins seen. A total of 95 MS lesions could be identified on both the T2-weighted series and the venograms; a central vein was visible in all 43 periventricular lesions and in all but one of the 52 focal deep white matter lesions. The typical ovoid shape and orientation of the long axis of the MS lesions correlated well with the course of these veins.
Conclusion:
With MR venography, the perivenous distribution of MS lesions in the brain can be visualized in vivo. The venous anatomy defines the typical form and orientation of these lesions.
Insights
Magnetic resonance venography reveals that multiple sclerosis (MS) brain lesions exhibit a perivenous distribution. This imaging technique visualizes how venous anatomy influences the characteristic shape and orientation of MS lesions in vivo.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple sclerosis (MS) brain lesions typically occur in periventricular and deep white matter regions.
- Histopathologic studies indicate a perivenous distribution pattern for MS lesions.
Purpose of the Study:
- To visualize the in vivo distribution patterns of MS brain lesions using high-resolution MR venography.
- To correlate observed lesion distribution with underlying venous anatomy.
Main Methods:
- Seventeen MS patients underwent 1.5 T MRI.
- MR venography was performed using a 3D gradient-echo technique.
- MS lesions on T2-weighted images were analyzed for shape, orientation, and location relative to venous anatomy.
Main Results:
- Contrast-enhanced MR venography improved visualization of small veins.
- A central vein was identified in 100% of periventricular and 98% of deep white matter MS lesions.
- The ovoid shape and long axis orientation of MS lesions correlated with adjacent venous structures.
Conclusions:
- MR venography effectively visualizes the perivenous distribution of MS brain lesions in vivo.
- Venous anatomy plays a crucial role in defining the characteristic morphology and orientation of MS lesions.