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The introduction of the CCSVI hypothesis in the diagnosis of MS has recently caused interest in intra- and extracranial venous flow measurements (1). Due to structural complexity and individual variations, flow studies in cerebrospinal veins using phase-contrast (PC) MR are rarely conducted (2). Though it has long been confirmed a source of variability in venous drainage to the heart (3), respiratory motion effects have been largely ignored in PC-MR, partially due to the difficulty and longer scan times of gating the respiratory and cardiac cycles. The purpose of this pilot study was to implement a dual-gated PC-MR sequence and investigate the effect of respiratory motion during free breathing on cerebrospinal venous flow.

Presented is a novel MR imaging protocol to comprehensively assess vessel lumen and hemodynamics of the cerebrospinal veins. The 3 station exam is designed to cover middle cerebral, jugular, and azygous veins in order to investigate the CCSVI hypothesis for the association of insufficient venous return with multiple sclerosis.