Clinical Classification and Collateral Circulation in Chronic Cerebrospinal Venous Insufficiency
Background: As an indispensable part of the cerebral venous system, the extracranial cerebrospinal venous system is not fully recognized. This study aimed to analyze the clinical classification and imaging characteristics of chronic cerebrospinal venous insufficiency (CCSVI) quantitatively.Methods:...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2020-09-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00913/full |
| _version_ | 1818060399489056768 |
|---|---|
| author | Zhongao Wang Zhongao Wang Zhongao Wang Jiayue Ding Jiayue Ding Jiayue Ding Chaobo Bai Chaobo Bai Chaobo Bai Yuchuan Ding Yuchuan Ding Yuchuan Ding Xunming Ji Xunming Ji Xunming Ji Ran Meng Ran Meng Ran Meng |
| author_facet | Zhongao Wang Zhongao Wang Zhongao Wang Jiayue Ding Jiayue Ding Jiayue Ding Chaobo Bai Chaobo Bai Chaobo Bai Yuchuan Ding Yuchuan Ding Yuchuan Ding Xunming Ji Xunming Ji Xunming Ji Ran Meng Ran Meng Ran Meng |
| author_sort | Zhongao Wang |
| collection | DOAJ |
| description | Background: As an indispensable part of the cerebral venous system, the extracranial cerebrospinal venous system is not fully recognized. This study aimed to analyze the clinical classification and imaging characteristics of chronic cerebrospinal venous insufficiency (CCSVI) quantitatively.Methods: A total of 128 patients, who were diagnosed as CCSVI by jugular ultrasound and contrast-enhanced magnetic resonance venography (CE-MRV), were enrolled from May 2018 through May 2019. For the patients with possible extraluminal compression, computed tomography venography (CTV) was applied to estimate the degree of internal jugular venous stenosis (IJVS) and rank the vertebral venous collateral circulation.Results: The causes of extraluminal compression induced IJVS included osseous compression (78.95%), carotid artery (24.21%), sternocleidomastoid muscle (5.79%), swollen lymph node (1.05%), and unknown reasons (5.26%). The subtypes of non-compression CCSVI included the high jugular bulb (77.27%), fenestration of the internal jugular vein (IJV) (7.27%), internal jugular phlebectasia (2.73%), tortuous IJV (0.91%), IJV thrombosis (14.55%), and elongated venous valves with/without erythrocyte aggregation (13.64%). For extraluminal compression induced IJVS, the ratio of severe vertebral venous expansion was higher in the severe IJVS group than that in the mild IJVS group (p < 0.001). The IJVS degree was higher in the severe vertebral venous expansion group than in the mild vertebral venous expansion group (p < 0.001).Conclusions: A multimodal diagnostic system is necessary to improve the diagnostic accuracy of CCSVI. The vertebral venous system is an important collateral circulation for CCSVI, which may be a promising indicator for evaluating IJVS degree. |
| first_indexed | 2024-12-10T13:31:48Z |
| format | Article |
| id | doaj.art-ecc2eb66950d480cb45cca723cb9624f |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-10T13:31:48Z |
| publishDate | 2020-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-ecc2eb66950d480cb45cca723cb9624f2022-12-22T01:46:58ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-09-011110.3389/fneur.2020.00913550675Clinical Classification and Collateral Circulation in Chronic Cerebrospinal Venous InsufficiencyZhongao Wang0Zhongao Wang1Zhongao Wang2Jiayue Ding3Jiayue Ding4Jiayue Ding5Chaobo Bai6Chaobo Bai7Chaobo Bai8Yuchuan Ding9Yuchuan Ding10Yuchuan Ding11Xunming Ji12Xunming Ji13Xunming Ji14Ran Meng15Ran Meng16Ran Meng17Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaAdvanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, ChinaDepartment of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaAdvanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, ChinaDepartment of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaAdvanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, ChinaDepartment of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United StatesAdvanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, ChinaDepartment of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaAdvanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, ChinaDepartment of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, ChinaBackground: As an indispensable part of the cerebral venous system, the extracranial cerebrospinal venous system is not fully recognized. This study aimed to analyze the clinical classification and imaging characteristics of chronic cerebrospinal venous insufficiency (CCSVI) quantitatively.Methods: A total of 128 patients, who were diagnosed as CCSVI by jugular ultrasound and contrast-enhanced magnetic resonance venography (CE-MRV), were enrolled from May 2018 through May 2019. For the patients with possible extraluminal compression, computed tomography venography (CTV) was applied to estimate the degree of internal jugular venous stenosis (IJVS) and rank the vertebral venous collateral circulation.Results: The causes of extraluminal compression induced IJVS included osseous compression (78.95%), carotid artery (24.21%), sternocleidomastoid muscle (5.79%), swollen lymph node (1.05%), and unknown reasons (5.26%). The subtypes of non-compression CCSVI included the high jugular bulb (77.27%), fenestration of the internal jugular vein (IJV) (7.27%), internal jugular phlebectasia (2.73%), tortuous IJV (0.91%), IJV thrombosis (14.55%), and elongated venous valves with/without erythrocyte aggregation (13.64%). For extraluminal compression induced IJVS, the ratio of severe vertebral venous expansion was higher in the severe IJVS group than that in the mild IJVS group (p < 0.001). The IJVS degree was higher in the severe vertebral venous expansion group than in the mild vertebral venous expansion group (p < 0.001).Conclusions: A multimodal diagnostic system is necessary to improve the diagnostic accuracy of CCSVI. The vertebral venous system is an important collateral circulation for CCSVI, which may be a promising indicator for evaluating IJVS degree.https://www.frontiersin.org/article/10.3389/fneur.2020.00913/fullchronic cerebrospinal venous insufficiencyinternal jugular veinclinical classificationvertebral venous systemcollateral circulation |
| spellingShingle | Zhongao Wang Zhongao Wang Zhongao Wang Jiayue Ding Jiayue Ding Jiayue Ding Chaobo Bai Chaobo Bai Chaobo Bai Yuchuan Ding Yuchuan Ding Yuchuan Ding Xunming Ji Xunming Ji Xunming Ji Ran Meng Ran Meng Ran Meng Clinical Classification and Collateral Circulation in Chronic Cerebrospinal Venous Insufficiency Frontiers in Neurology chronic cerebrospinal venous insufficiency internal jugular vein clinical classification vertebral venous system collateral circulation |
| title | Clinical Classification and Collateral Circulation in Chronic Cerebrospinal Venous Insufficiency |
| title_full | Clinical Classification and Collateral Circulation in Chronic Cerebrospinal Venous Insufficiency |
| title_fullStr | Clinical Classification and Collateral Circulation in Chronic Cerebrospinal Venous Insufficiency |
| title_full_unstemmed | Clinical Classification and Collateral Circulation in Chronic Cerebrospinal Venous Insufficiency |
| title_short | Clinical Classification and Collateral Circulation in Chronic Cerebrospinal Venous Insufficiency |
| title_sort | clinical classification and collateral circulation in chronic cerebrospinal venous insufficiency |
| topic | chronic cerebrospinal venous insufficiency internal jugular vein clinical classification vertebral venous system collateral circulation |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00913/full |
| work_keys_str_mv | AT zhongaowang clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT zhongaowang clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT zhongaowang clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT jiayueding clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT jiayueding clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT jiayueding clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT chaobobai clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT chaobobai clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT chaobobai clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT yuchuanding clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT yuchuanding clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT yuchuanding clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT xunmingji clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT xunmingji clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT xunmingji clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT ranmeng clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT ranmeng clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency AT ranmeng clinicalclassificationandcollateralcirculationinchroniccerebrospinalvenousinsufficiency |