Quantitative ColourDopplerSonography evaluation of cerebral venous outflow: a comparative study between patients with multiple sclerosis and controls.

<h4>Background</h4>Internal Jugular Veins (IJVs) are the principle outflow pathway for intracranial blood in clinostatism condition. In the seated position, IJVs collapse, while Vertebral Veins (VVs) increase the venous outflow and partially compensate the venous drainage. Spinal Epidura...

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Autores principales:	Lucia Monti, Elisabetta Menci, Monica Ulivelli, Alfonso Cerase, Sabina Bartalini, Pietro Piu, Nicola Marotti, Sara Leonini, Paolo Galluzzi, Daniele G Romano, Alfredo E Casasco, Carlo Venturi
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ec438aa8c6e746979d4ed5c26d136c48
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spelling	oai:doaj.org-article:ec438aa8c6e746979d4ed5c26d136c482021-11-04T06:08:02ZQuantitative ColourDopplerSonography evaluation of cerebral venous outflow: a comparative study between patients with multiple sclerosis and controls.1932-620310.1371/journal.pone.0025012https://doaj.org/article/ec438aa8c6e746979d4ed5c26d136c482011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21966398/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Internal Jugular Veins (IJVs) are the principle outflow pathway for intracranial blood in clinostatism condition. In the seated position, IJVs collapse, while Vertebral Veins (VVs) increase the venous outflow and partially compensate the venous drainage. Spinal Epidural Veins are an additional drainage pathway in the seated position. Colour- Doppler-Sonography (CDS) examination is able to demonstrate IJVs and VVs outflow in different postural and respiratory conditions. The purpose of this study was to evaluate CDS quantification of the cerebral venous outflow (CVF) in healthy subjects and patients with multiple sclerosis (MS).<h4>Methodology/principal findings</h4>In a group of 27 healthy adults (13 females and 14 males; mean age 37.8 ± 11.2 years), and 52 patients with MS (32 females and 20 males; mean age 42.6 ± 12.1 years), CVF has been measured in clinostatism and in the seated position as the sum of the flow in IJVs and VVs. The difference between CVF in clinostatism and CVF in the seated position (ΔCVF) has been correlated with patients' status (healthy or MS), and a number of clinical variables in MS patients. Statistical analysis was performed by Fisher's exact test, non-parametric Mann-Whitney U test, ANOVA Kruskal-Wallis test, and correntropy coefficient. The value of ΔCVF was negative in 59.6% of patients with MS and positive in 96.3% of healthy subjects. Negative ΔCVF values were significantly associated with MS (p<0.0001). There was no significant correlation with clinical variables.<h4>Conclusions/significance</h4>Negative ΔCVF has a hemodynamic significance, since it reflects an increased venous return in the seated position. This seems to be a pathologic condition. In MS patients, a vascular dysregulation resulting from involvement of the autonomous nervous system may be supposed. ΔCVF value should be included in the quantitative CDS evaluation of the cerebral venous drainage, in order to identify cerebral venous return abnormalities.Lucia MontiElisabetta MenciMonica UlivelliAlfonso CeraseSabina BartaliniPietro PiuNicola MarottiSara LeoniniPaolo GalluzziDaniele G RomanoAlfredo E CasascoCarlo VenturiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 9, p e25012 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lucia Monti Elisabetta Menci Monica Ulivelli Alfonso Cerase Sabina Bartalini Pietro Piu Nicola Marotti Sara Leonini Paolo Galluzzi Daniele G Romano Alfredo E Casasco Carlo Venturi Quantitative ColourDopplerSonography evaluation of cerebral venous outflow: a comparative study between patients with multiple sclerosis and controls.
description	<h4>Background</h4>Internal Jugular Veins (IJVs) are the principle outflow pathway for intracranial blood in clinostatism condition. In the seated position, IJVs collapse, while Vertebral Veins (VVs) increase the venous outflow and partially compensate the venous drainage. Spinal Epidural Veins are an additional drainage pathway in the seated position. Colour- Doppler-Sonography (CDS) examination is able to demonstrate IJVs and VVs outflow in different postural and respiratory conditions. The purpose of this study was to evaluate CDS quantification of the cerebral venous outflow (CVF) in healthy subjects and patients with multiple sclerosis (MS).<h4>Methodology/principal findings</h4>In a group of 27 healthy adults (13 females and 14 males; mean age 37.8 ± 11.2 years), and 52 patients with MS (32 females and 20 males; mean age 42.6 ± 12.1 years), CVF has been measured in clinostatism and in the seated position as the sum of the flow in IJVs and VVs. The difference between CVF in clinostatism and CVF in the seated position (ΔCVF) has been correlated with patients' status (healthy or MS), and a number of clinical variables in MS patients. Statistical analysis was performed by Fisher's exact test, non-parametric Mann-Whitney U test, ANOVA Kruskal-Wallis test, and correntropy coefficient. The value of ΔCVF was negative in 59.6% of patients with MS and positive in 96.3% of healthy subjects. Negative ΔCVF values were significantly associated with MS (p<0.0001). There was no significant correlation with clinical variables.<h4>Conclusions/significance</h4>Negative ΔCVF has a hemodynamic significance, since it reflects an increased venous return in the seated position. This seems to be a pathologic condition. In MS patients, a vascular dysregulation resulting from involvement of the autonomous nervous system may be supposed. ΔCVF value should be included in the quantitative CDS evaluation of the cerebral venous drainage, in order to identify cerebral venous return abnormalities.
format	article
author	Lucia Monti Elisabetta Menci Monica Ulivelli Alfonso Cerase Sabina Bartalini Pietro Piu Nicola Marotti Sara Leonini Paolo Galluzzi Daniele G Romano Alfredo E Casasco Carlo Venturi
author_facet	Lucia Monti Elisabetta Menci Monica Ulivelli Alfonso Cerase Sabina Bartalini Pietro Piu Nicola Marotti Sara Leonini Paolo Galluzzi Daniele G Romano Alfredo E Casasco Carlo Venturi
author_sort	Lucia Monti
title	Quantitative ColourDopplerSonography evaluation of cerebral venous outflow: a comparative study between patients with multiple sclerosis and controls.
title_short	Quantitative ColourDopplerSonography evaluation of cerebral venous outflow: a comparative study between patients with multiple sclerosis and controls.
title_full	Quantitative ColourDopplerSonography evaluation of cerebral venous outflow: a comparative study between patients with multiple sclerosis and controls.
title_fullStr	Quantitative ColourDopplerSonography evaluation of cerebral venous outflow: a comparative study between patients with multiple sclerosis and controls.
title_full_unstemmed	Quantitative ColourDopplerSonography evaluation of cerebral venous outflow: a comparative study between patients with multiple sclerosis and controls.
title_sort	quantitative colourdopplersonography evaluation of cerebral venous outflow: a comparative study between patients with multiple sclerosis and controls.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/ec438aa8c6e746979d4ed5c26d136c48
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Quantitative ColourDopplerSonography evaluation of cerebral venous outflow: a comparative study between patients with multiple sclerosis and controls.

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