MR venography of multiple sclerosis

BACKGROUND AND PURPOSE: The distribution of multiple sclerosis (MS) lesions in the brain follows a specific pattern, with most lesions in the perivent ricular regions and in the deep white matter; histopathologic studies have shown a perivenous distribution. The aim of this study was to illustrate th ese distribution patterns in vivo using high-resolution MR venography. METHODS: Seventeen MS patients underwent MR imaging at 1.5 T. Venographic s tudies were obtained with a 3D gradient-echo technique. MS lesions were ide ntified on T2-weighted images, and their shape, orientation, and location w ere compared with the venous anatomy on the venograms, RESULTS: The use of contrast material facilitated the visualization of smal l veins and increased the number of veins seen. A total of 95 MS lesions co uld be identified on both the T2-weighted series and the venograms; a centr al vein was visible in all 43 periventricular lesions and in all but one of the 52 focal deep white matter lesions. The typical ovoid shape and orient ation of the long axis of the MS lesions correlated well with the course of these veins. CONCLUSION: With MR venography, the perivenous distribution of MS lesions i n the brain can be visualized in vivo. The venous anatomy defines the typic al form and orientation of these lesions.