Secondary cerebrovenous outflow in relation to duration of disease in patients with multiple sclerosis

Aims: Previous studies show an increased secondary venous outflow in patients with MS. The aim of this study was to determine whether the degree of drainage through secondary venous channels is related to the duration of the disease.

Methods: We examined 40 patients at the age of 12 to 63 years (mean 31.7 years, 1st quartile: 20.5 years, 3rd quartile: 38.5 years) with multiple sclerosis. Mean value of the duration of disease was 7.1 years (1st quartile: 2.0 years, 3rd quartile: 11.0 years). To visualize primary veins (left and right internal jugular vein – LIJV, RIJV) and secondary veins (right and left vertebral vein – VV, epidural vein – EV, deep cervical vein – DCV) a 2D time-of-flight MR-venography (MRV) of the upper cervical regions was performed. MRVs were visually analyzed and secondary venous outflow was graded: 1– no; 2– minimal; 3– mild secondary venous outflow; 4– pronounced secondary venous outflow in one of the three pathways (VV, EV or DCV); 5– secondary venous outflow in two of the three pathways and 6– secondary venous outflow in all three pathways. The statistical evaluation was implemented by means of multiple regression analysis.

Results: 1 patient was classified in grade 1, 4 patients were classified in grade 2, 6 patients were classified in grade 3, 13 patients were classified in grade 4, 16 patients were classified in grade 5, no patient was classified in grade 6. The degree of secondary venous drainage is significantly and positively related to duration of disease (p-value=0.0331).

Conclusion: In the examined group patients with a longer existing MS disease have more venous outflow in secondary veins than patients with a shorter duration of disease. We draw the conclusion that secondary venous drainage indicates duration of disease in patients with MS.

Multiple sclerosis - secondary venous outflow - secondary veins - duration of disease