Table 2:

Ultrasound criteria for chronic cerebrospinal vascular insufficiency in patients with multiple sclerosis and healthy controls

Criterion*No. (%) of participantsp valueOR (95% CI)
Patients
n = 115
Controls
n = 60
Criterion 1: reflux (IJV, VV: right and left, upright and supine)0.3
None68 (59)30 (50)
1 vein25 (22)22 (37)
2 veins11 (10)5 (8)
3 veins9 (8)3 (5)
4 veins2 (2)0 (0)
Criterion 3: IJV stenosis (right and left)0.4
Both normal89 (77)52 (87)
1 abnormal17 (15)6 (10)
2 abnormal9 (8)2 (3)
Criterion 4: no Doppler-detectable flow (IJV, VV: right and left, upright and supine)> 0.9
Normal113 (98)59 (98)
1 vein2 (2)1 (2)
Criterion 5: negative CSA in IJV (right and left)0.2
Change in CSA > 094 (82)54 (90)
Change in CSA ≤ 021 (18)6 (10)
No. of ultrasound criteria met
≥ 167 (58)38 (63)0.60.9 (0.4–1.6)
≥ 223 (20)6 (10)0.12.2 (0.8–7.2)
≥ 36 (5)1 (2)0.53.2 (0.3–151.8)
≥ 40 (0)0 (0)NANA
048 (42)22 (37)0.6
Exactly 144 (38)32 (53)0.08
Exactly 217 (15)5 (8)0.3
Exactly 36 (5)1 (2)0.4
Exactly 40 (0)0 (0)NA
  • Note: CI = confidence interval, CSA = cross-sectional area, IJV = internal jugular vein, NA = not applicable, OR = odds ratio, VV = vertebral vein

  • * All criteria as presented by Zamboni and colleagues. (3), (4) Criterion 1 = reflux in the IJVs and/or VVs in sitting or supine position, defined as reflux > 0.88 s; criterion 3 = Doppler B-mode evidence of IJV stenosis, defined as local reduction of cross-sectional area < 50% and/or < 0.3 cm2 in supine position; criterion 4 = flow not Doppler-detectable in the IJVs and/or VVs; criterion 5, reverted postural control of the main cerebral venous outflow. For the current study, criterion 2 (transcranial Doppler assessment of internal cerebral veins) was not performed.

  • Except where indicated otherwise.

  • Fisher’s exact test for patients and controls meeting 1 or more US criteria, 2 or more US criteria, 3 or more US criteria, or 4 or more US criteria.