Characteristics of flow through the internal jugular veins at cervical C2/C3 and C5/C6 levels for multiple sclerosis patients using MR phase contrast imaging

Objectives: To study blood flow characteristics through the internal jugular veins (IJVs) at the cervical levels C2/C3 and C5/C6 in the neck of multiple sclerosis (MS) patients. Methods: Magnetic resonance imaging at 3T was performed on 323 MS patients. Phase contrast imaging was used to quantify blood flow at both the C2/C3 and C5/C6 levels. Total IJV flow (tIJF) was normalized by total arterial flow (tAF). Contrast-enhanced time-resolved 3D MR arteriovenography and 2D time-of-flight MR venography were performed to assess IJV anatomy. Based on this assessment, the MS population was divided into non-stenotic (NST) and stenotic (ST) subjects. Results: Of all the patients, 100 (31%) belonged to the NST group and 223 (69%) belonged to the ST group. At the C2/C3 and C5/C6 levels, the normalized tIJF of the ST group was 56 +/- 26% and 51 +/- 23%, respectively. This was significantly lower than that of the NST group, 85 +/- 85 +/- and 73 +/- 12% (P<0.001). Zero percent and 5% of the NST group had a normalized tIJF of less than 50% at the C2/C3 and C5/C6 levels, compared to 37% and 47% for the ST group. The tAF was smaller for the secondary and primary progressive MS patients than the relapsing remitting MS patients (P=0.02 and 0.01, respectively), while the tIJF was similar among all MS types. Conclusion: Total blood flow through the IJVs at both the C2/C3 and C5/C6 levels was reduced in the ST group compared to the NST group.