Contributions
Abstract: EP1539
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Purpose: Our aim was to use a novel time-resolved magnetic resonance (MR) technique, for high contrast enhanced venography with high temporal resolution, as an objective method for the assessment of cerebral venous hemodynamics in patients with multiple sclerosis (MS), their healthy siblings, and unrelated healthy controls.
Materials and methods:39 patients with clinically definite MS, 31 siblings and 31 unrelated controls were recruited and imaged between January and December 2011. Dynamic magnetic resonance angiography data were acquired using 4D-TRAK on a 3T Philips Achieva scanner. Two blinded readers assessed contrast arrival times over 68 time points while reviewing the upper and lower cross sections of the carotid arteries and the internal jugular veins (IJV) for maximum contrast. We further computed the cerebral circulation times (CCT) as the arrival time to the IJV minus the arrival time to the arteries based on the two manually defined landmarks. Statistical analysis was done using Kruskal-Wallis and ANCOVA, taking the age as a covariant.
Results:The median left and right CCTs were 6.14s for patients, 6.24s for siblings, and 6.14s for unrelated controls for the upper landmarks and 7.80s for patients, 7.60s for siblings, and 7.80s for unrelated controls for the lower landmark. No significant differences in the CCTs were found between the three groups (p > 0.2). Furthermore, no correlations were found between the CCTs and the brain volumes, expanded disability status scale (EDSS) or disease duration.
Conclusion:The lack of significant differences in venous flow between patients with MS, their siblings and unrelated controls on MR venography suggests that flow abnormalities are not characteristic for MS. Our results directly contradict previous findings obtained using ultrasound but agree with results obtained with catheter venography.
Disclosure: Data acquisition funded by the MS Society of Canada.
Enedino Hernández-Torres has nothing to disclose.
Fergus Cafferty has nothing to disclose.
David Li has received research funding from the Canadian Institute of Health Research and Multiple Sclerosis Society of Canada. He is the Emeritus Director of the UBC MS/MRI Research Group which has been contracted to perform central analysis of MRI scans for therapeutic trials with Novartis, Perceptives, Roche and Sanofi-Aventis. The UBC MS/MRI Research Group has also received grant support for investigator-initiated independent studies from Genzyme, Merck-Serono, Novartis and Roche. He has acted as a consultant to Vertex Pharmaceuticals and served on the Data and Safety Advisory Board for Opexa Therapeutics and Scientific Advisory Boards for Adelphi Group, Celgene, Novartis and Roche. He has also given lectures which have been supported by non-restricted education grants from Teva, Novartis and Biogen.
Lindsay Machan is a member of the Research Steering Committee for Cook Inc and Medical Advisory Board for Boston Scientific Corp.
Dessa Sadovnick has received personal compensation for activities with Biogen Idec, Merck Serono, Teva Neuroscience, and Bayer Pharmaceuticals Corp as a speaker.
Anthony Traboulsee received research support from Biogen, Chugai, CIHR, Roche, Michael Smith Foundation, MS Society of Canada and consulted for Biogen, Roche, EMD Serono, Teva Pharmaceuticals.
Alexander Rauscher received research support NSERC and National MS Society.
Abstract: EP1539
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Purpose: Our aim was to use a novel time-resolved magnetic resonance (MR) technique, for high contrast enhanced venography with high temporal resolution, as an objective method for the assessment of cerebral venous hemodynamics in patients with multiple sclerosis (MS), their healthy siblings, and unrelated healthy controls.
Materials and methods:39 patients with clinically definite MS, 31 siblings and 31 unrelated controls were recruited and imaged between January and December 2011. Dynamic magnetic resonance angiography data were acquired using 4D-TRAK on a 3T Philips Achieva scanner. Two blinded readers assessed contrast arrival times over 68 time points while reviewing the upper and lower cross sections of the carotid arteries and the internal jugular veins (IJV) for maximum contrast. We further computed the cerebral circulation times (CCT) as the arrival time to the IJV minus the arrival time to the arteries based on the two manually defined landmarks. Statistical analysis was done using Kruskal-Wallis and ANCOVA, taking the age as a covariant.
Results:The median left and right CCTs were 6.14s for patients, 6.24s for siblings, and 6.14s for unrelated controls for the upper landmarks and 7.80s for patients, 7.60s for siblings, and 7.80s for unrelated controls for the lower landmark. No significant differences in the CCTs were found between the three groups (p > 0.2). Furthermore, no correlations were found between the CCTs and the brain volumes, expanded disability status scale (EDSS) or disease duration.
Conclusion:The lack of significant differences in venous flow between patients with MS, their siblings and unrelated controls on MR venography suggests that flow abnormalities are not characteristic for MS. Our results directly contradict previous findings obtained using ultrasound but agree with results obtained with catheter venography.
Disclosure: Data acquisition funded by the MS Society of Canada.
Enedino Hernández-Torres has nothing to disclose.
Fergus Cafferty has nothing to disclose.
David Li has received research funding from the Canadian Institute of Health Research and Multiple Sclerosis Society of Canada. He is the Emeritus Director of the UBC MS/MRI Research Group which has been contracted to perform central analysis of MRI scans for therapeutic trials with Novartis, Perceptives, Roche and Sanofi-Aventis. The UBC MS/MRI Research Group has also received grant support for investigator-initiated independent studies from Genzyme, Merck-Serono, Novartis and Roche. He has acted as a consultant to Vertex Pharmaceuticals and served on the Data and Safety Advisory Board for Opexa Therapeutics and Scientific Advisory Boards for Adelphi Group, Celgene, Novartis and Roche. He has also given lectures which have been supported by non-restricted education grants from Teva, Novartis and Biogen.
Lindsay Machan is a member of the Research Steering Committee for Cook Inc and Medical Advisory Board for Boston Scientific Corp.
Dessa Sadovnick has received personal compensation for activities with Biogen Idec, Merck Serono, Teva Neuroscience, and Bayer Pharmaceuticals Corp as a speaker.
Anthony Traboulsee received research support from Biogen, Chugai, CIHR, Roche, Michael Smith Foundation, MS Society of Canada and consulted for Biogen, Roche, EMD Serono, Teva Pharmaceuticals.
Alexander Rauscher received research support NSERC and National MS Society.