The Average Cerebral Perfusion in Patients with Multiple Sclerosis (MS) using MRI

Flow and structural related studies of the vasculature of the head and neck have indicated that venous outflow may be obstructed in MS patients, with postulation that this leads to the development or exacerbation of the disease. The current work presented in the following is to determine if there is correlation between abnormal internal jugular vein (IJV) flow and average cerebral blood flow in MS patients. 140 MS patients, 117 of known MS type, and 26 healthy controls were imaged by 3-T MRI. 3D contrast-enhanced MR angiography was assessed for structural abnormalities of the IJV, and the MS group was subdivided into two groups; those with stenosis and those without. Velocity encoded phase contrast MR data was processed to quantify flow through major arteries and veins of the neck. The average cerebral blood flow (CBF) was calculated by normalizing the total arterial blood flow to the brain, taken by adding the flow of the internal carotid arteries and vertebral arteries at the C2 vertebral level, by the total brain volume quantified from 3D FLAIR data. The average CBF as a function of total IJV flow at the C6 vertebral level was presented. The MS patients without stenosis show a linear trend in average CBF vs total IJV flow, indicating a potential relationship between arterial flow to the brain and effective drainage in the supine position through the IJV. Future research may indicate potential flow related biomarkers which further separate healthy controls and MS patients.