Material/Methods: Background: Results: Conclusions: Key words: O R I G I N A L A R T I C L E Magnetic Resonance Venography of chronic cerebrospinal venous insufficiency in patients with associated multiple sclerosis Marcin Hartel1, Ewa Kluczewska1,2, Marian Simka3, Tomasz Ludyga3, Jacek Kostecki4, Maciej Zaniewski4 1 MCD Voxel, MRI Department, Zabrze, Poland 2 Radiology Department in Zabrze, Medical Uniwersity of Silesia, Katowice, Poland 3 EUROMEDIC Specialist Clinics, Department of Vascular & Endovascular Surgery, Katowice, Poland 4 General and Vascular Surgery Department in Tychy, Medical University of Silesia, Katowice, Poland Author’s address: Marcin Hartel, Reta 39G Str., 43-190 Mikołów, Poland, e-mail: hartel@voxel.pl Summary Multiple sclerosis (MS) is a chronic disease with not well understood etiology. Recently, a possible association of MS with compromised venous outflow from the brain and spinal cord has been studied (chronic cerebrospinal venous insufficiency – CCSVI). Angioplasties of internal jugular veins (IJV) and azygous vein (AV) have given promising results, with improvements in patients’ clinical status. 830 patients with clinically defined MS were scanned from the level of sigmoid sinuses to the junction with brachiocephalic veins, as well as at the level of AV. T2-weighted, 2D TOF and FIESTA sequences were used. The examination revealed a slower blood flow in IJVs, in 98% of patients: on the right side – in 6%, on the left side – in 15%, on both sides with right-side predominance – in 22%, on both sides with left-side predominance – in 34%, bilaterally with no side predominance – in 19%. In 2%, there was a slower blood flow in IJVs, vertebral veins and subclavian veins and also in the left brachiocephalic vein. Moreover, in 5% of patients there was a decreased blood flow in the azygous vein. Abnormal flow pattern in IJVs is more common on the left side. Less often it can be found in azygous vein and in brachiocephalic veins. Further research is needed to investigate the significance of CCSVI in MS patients. The protocol we described can be used for most of modern magnetic resonance units. CCSVI • chronic cerebro-spinal venous insufficiency • multiple sclerosis • magnetic resonance venography Signature: © Pol J Radiol, 2011; 76(1): 59-62 Received: 2011.01.12 Accepted: 2011.01.27 PDF file: http://www.polradiol.com/fulltxt.php?ICID=881410 Background Multiple sclerosis (MS) is a well known chronic disease of the central nervous system. Despite decades of research on MS, its etiology is not well understood [1–5]. Recently, a new paradigm of MS has been studied intensively: a possible association of MS with compromised venous outflow from the brain and spinal cord, the so called chronic cerebrospinal venous insufficiency (CCSVI) [6–12]. Angioplasties of internal jugular veins (IJV) and azygous vein (AV), performed since 2007, have given promising results, with improvements in patients’ clinical status [13–16]. This report focused on one of the pre-procedural tests that are used to diagnose CCSVI, namely magnetic resonance venography (MRV) [17–19]. Material and Methods Between July 2009 and December 2010, we scanned 830 patients (623 women and 207 men, with a mean age of 46 years). All the patients presented with clinically defined MS. They had also been previously diagnosed for CCSVI using color Doppler sonography with a protocol of the test proposed 59