The IMPRESSION sections of MRV, US & venogram reports

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

The IMPRESSION sections of MRV, US & venogram reports

Postby HappyPoet » Mon Feb 22, 2010 10:17 am

A log of the IMPRESSION sections of test reports could be informative; hopefully many people will participate.

Zamboni's Five Criteria - two must be present for a CCSVI diagnosis:

1. Reflux in the IJVs and/or VVs in sitting and supine posture;
2. Reflux in the DCVs;
3. High-resolution B-mode evidence of IJV stenoses;
4. Flow not Doppler-detectable in the IJVs and/or VVs;
5. Reverted postural control of the main cerebral venous outflow pathways.


RRMS diagnosed May, 2000 by MS specialist (lifelong symptoms)
CCSVI diagnosed Feb, 2010 by PCP (neuro not interested), but I will be getting a second opinion from a vascular surgeon because I don't really know if my primary understands Zamboni's criteria.

MRV-head: "Abnormal examination with absent proximal segment of left transverse sinus and markedly attenuated remainder of left transverse sinus and left sphenoid sinus."

US: "Evaluation of jugular venous flow in upright position must be considered abnormal on right side." (From FINDINGS section: "Right jugular vein Upright velocity is anomalous measuring 175.0 cm/sec.")

Edited to include the words 'From FINDINGS section:' and to put quotes around that text.

Last edited by HappyPoet on Thu Apr 08, 2010 11:00 am, edited 1 time in total.
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Postby Brightspot » Wed Feb 24, 2010 10:38 am

For what it is worth here is a translation (from Spanish) of the "Conclusions" section of my MRV.

CONCLUSION: hypoplasia of the transverse sinus left with a minor flow toward the gulf of left jugular. The rest of the neck vein MRI in normal limits.

In the body of the report is the following "poor shape is displayed in paraverterbral venous return, probably as a variant".

The radiologist said he had no experience in this area, but had read something about Zamboni's work and used Haake's protocol. He was not encouraging about the concept of CCSVI. He came accross as a conservative, caring person, and he included an MRI of my brain at no cost, as he wanted me to have something that might be usefull when I next saw my neurologist. (My neurologist has no interest in my MRV, and no interest in refering me to anyone who might be interested).I have been reading all I can, and looking at whatever MRVs I can find posted and going over my MRV frame by frame, as my GP was not interested in the least. She glanced at the translated conclusions and dismissed the report.
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Postby Bobbi » Tue Mar 02, 2010 10:40 am

Date/Location of testing: Jan 5 2010, Buffalo, New York
Type of testing: 2D, Doppler ultrasound
Diagnosis: Inconclusive evidence regarding jugular thrombosis or stenosis.
Date/Location of testing: Jan 19 2010, Niagara Vascular Lab, Canada
Type of Procedure: Ultrasound: Bilateral non-invasive assessment veins. B-mode and duplex imaging were employed. Compression maneuvers were performed.
Diagnosis: RIGHT SIDE: The max transverse diameter of the internal jugular vein is 1.4 cm, proximally, 1.8 cm in mid portion and 1.2 cm distally. Non-occlusive thrombus (unobstructed).
LEFT SIDE: The max transverse diameter of the proximal internal jugular vein is 1.4 cm, in the mid portion .8 cm and in the distal part .8 cm. Narrowing of the left jugular with possible "calcuim" deposits.
My Summary: Dr would not comment on connection to CCSVI ... but to me it looks like my left jugular vein has narrowing and some blockage issues.
NEXT STEP: Wait and see what happens with study results. Possible MRV in US.
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Postby babiezuique » Tue Mar 02, 2010 11:41 am

i had a CRANIOCERVICAL DOPPLER DONE in the westmount square medical imaging in Montreal. They say they follow the zamboni's protocol. The only test they offer to diagnose CCSVI is this craniocervical venous doppler. They dont offer neither the extracranial doppler neither the MRV. We all know that a venour doppler is not enougnt to conclude anything.

this is the result a received from them:

Final diagnostic imaging report from DR Jeff CHankowsky he is a neuro radiologist who work at MC Gill Hospital

Craniocervical venous doppler


The examination was perform according to Zamboni protocol, evaluating the cervical, jugular and vertebral venous system, both supine an upright.


Both internal jugular veins demonstrate prominent cardiocentric flow in the supine position, wich is normal. Very tiny amounts of reflux are seen
lasting less than 0,25 seconds, wich is normal. In the upright position, both internal jugular veins collapsed significantly, wich is an expected finding.

No anatomical stenoses nor compressions of the jugular veins are noted.

In the supine position, the vertebral veins demonstrate proper flow toward the heart. However there is a definite left vertebral venous reflux with the head rotated to the right in the supine position. This reflus is sustained and is pathological.

The remainder of the study demonstrates no other fondings that are pathological.


This study demonstrates only one pathological entity, wich is susustained reflux in the vein int he upright position,wich only satisfies one of the five Zamboni's criteria for a positive screening doppler examination. Acording to the recent publication, at least two findings should be present for the study to be consider a positive screening study.

Therefore, this study demonstrates one abnormality, which might be an incidental finding.

Reported by doctor Jeff Chankowsky Mc Gill Hospital

1- how come they tell me i dont encounter the CCSVI criteria for a ccsvi while I only did a doppler that is not an extracranial one... They tell me i dont have ccsvi.... but this test can not be in any way conclusive.

I need your point of view on this!
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