This Is MS Multiple Sclerosis Community: Knowledge & Support

MRV < Doppler < Catheter Venogram < Catheter Venogram with IVUS or Catheter Venogram with Sinan's method of Azygous Diagnostic Ballooning

Dr Haacke is working very hard to move MRV up in that ranking and where does fMRI (Dr Hubbard) fit in? or does it?

teacha teacha teeeeach me.. Sorry, Halloween hangover

Abstract
...
Flow quantification showed no venous backflow in any MS patient or control.
...

2000 plus people have been de-stenosed after diagnosis with selective venography. This Dutch study is poor science and meaningless in size against 2000 real pwMS. Let's move on to real science not this rubbish.
Read Sclafani's paper on how to diagnose it you want to learn more.

This Dutch study is poor science and meaningless in size against 2000 real pwMS. Let's move on to real science not this rubbish.

The paper can be found here:
http://www.overcomingmultiplesclerosis. ... ntId=20084
(there is a small delay in displaying the pdf)

We have to be aware that all available standard imaging approaches for the evaluation of the cranial venous system represent rather a snapshot. The venous blood flow is influenced by many different physiological factors and their interaction such as respiratory changes, swallowing, central venous pressure, position of the patient (supine, sitting, upright), muscle contraction, etc. Regarding the analysis of the intracranial and cervical venous systems, it is almost impossible to take all of these factors into account, regardless of the imaging modality used.

Venous backflow alias "Reflux in the brain" is a Bogeyman of CCSVI theory, monstrous imaginary figure used in threatening MS-patients. This legendary monster has no specific appearance, no evidence of existing, non explainable by any hemodynamic theory. He simply has no set appearance, but is just an amorphous embodiment of terror. Just endless repeating .... If you are not Liberated, the bogeyman will get you and eat your brain!

LET ME TRY TO INTERPRET THIS INTO ENGLISH FOR YOU. MY TRANSLATION WILL FOLLOW PART OF THE REPORT IN ALLCAPS


REPORT


SUPINE STUDY:

Right IJV Cross-sectional area: 17.5mm^2
Left IJV Cross-sectional area: 30.5mm^2

IN THE LYING DOWN POSITION, THE LAB HAS MEASURED THE AREA OF THE CIRCUMFERENCE OF THE JUGULAR VEIN. AS YOU CAN SEE THE AREA OF THE LEFT IS ALMOST TWICE THAT OF THE RIGHT. HOWEVER COMPARISON OF RIGHT AND LEFT DO NOT HAVE SIGNIFICANCE. COMPARISON OF LYING DOWN AND SITTING UP IS IMPORTANT.

Prominent echogenic bands in the J1 segment of the left IJV
ECHOGENIC BANDS ARE SOUND REFLECTIONS OF TISSUE, IT COULD BE BANDS, ABNORMAL VALVES, SEPTATIONS, ETC THIS IS A B-MODE ABNORMALITY


Intermittent retrograde flow in the J2 segment of the left IJV
PERIODIC FLOW BACK UP TOWARD THE HEAD IN THE MIDDLE OF THE JUGULAR VEIN. THIS IS ABNORMAL. WE CALL IT REFLUX.

[b]Normal antegrade flow in the right IJV, vertebral, and deep cerebral veins.
BUT THAT REVERSED FLOW ONLY OCCURS IN THE LEFT INTERNAL JUGULAR VEIN. THE OTHER MEASURED VEINS HAVE FLOW IN THE CORRECT DIRECTION. THIS ZAMBONI CRITERIA IS MET WHEN ANY OF THE VEINS FLOW BACKWARD. YOU DO NOT HAVE TO HAVE IT IN MORE THAN ONE OF THE VEINS.

UPRIGHT STUDY: USUALLY DONE SITTING UP, NOT STANDING.

Right IJV Cross-sectional area: 21.4mm^2 (change from supine= -3.9mm^2

THE CROSS SECTIONAL AREA DIFFERENCE BETWEEN UPRIGHT AND LYING DOWN ON THE RIGHT (ALSO KNOWN AS DELTA CSA). WHEN YOU SUBTRACT THE UPRIGHT FROM THE SUPINE AND GET A NEGATIVE NUMBER, THAT MEANS THAT THE CSA IS LARGER UPRIGHT THAN SUPINE. NORMALLY THE VEIN GETS SMALLER WHEN YOU ARE UPRIGHT BECAUSE THE FLOW NORMALLY GOES THROUGH THE VERTEBRAL VEIN WHEN SITTING AND STANDING.

Left IJV Cross-sectional area: 4.8mm^2(change from supine= +25.7mm^2
THIS IS WHAT IS NORMALLY SUPPOSED TO HAPPEN. THE VEIN IS BIGGER SUPINE THAN UPRIGHT.

Normal antegrade flow in the IJV and vertebral veins

ANTEGRADE FLOW MEANS THAT THE FLOW IN THE VEIN IS BACK TO THE HEART. tHIS IS THE DIRECTION VENOUS BLOOD IS SUPPOSED TO GO.

Retrograde flow in the deep cerebral veins
THE FLOW IN THE DEEP CEREBRAL VEINS IS GOING BACK TOWARD THE HEAD. THIS IS NOT WHAT IS SUPPOSED TO HAPPEN;. THIS IS ABNORMAL. THIS IS THE PART OF THE TEST THAT IS DONE WITH THE PROBE AGAINST THE TEMPLE OR NEAR THE EAR. IT IS CALLED TRANSCRANIAL DOPPLER.

INTERPRETATION:

1. Criteria for CCSVI 4/5 (qualifying factor for CCSVI is 2/5)
THE FIVE CRITERIA ARE
1. REVERSAL OF FLOW IN AN IJV OR VERTEBRAL VEIN (YOU HAVE THIS)
2. REVERSAL OF FLOW IN THE DEEP CEREBRAL VEINS (YOU HAVE THIS)
3. ABSENCE OF FLOW FOR PART OF THE VASCULAR CYCLE(YOU DO NOT HAVE THIS)
4. A NEGATIVE DELTA OF CSA (YOU HAVE THIS)
5. B-MODE ABNORMALITIES LIKE STENOSES, THICK VALVES, (YOU HAVE THIS)

I hope this helps[/b]

The pictures included were lovely, with gorgeous, open veins and nothing like the pics I've been seeing of MS patients from Dake and Haacke's MRVs. And not like Jeff's mangled jugulars and squirrelly collaterals at all....
cheer

Cheer, you cheered me up for sure! I would really like to hear what Haacke has to say about this study. But you're right, from the figures, both the MS and control subjects in the study appear to have enviable veins.

Perhaps the Dutch, even those with MS, are beautiful people with lovely veins???

I almost feel like saying, ala Crocodile Dundee, you're calling that a stenosis mate?

THIS is a stenosis.

Pshaw! Do you call that a stenosis? I'll see your stenosis, and raise you two - a la Alligator Johnson (but not really).

I'm not really trying to one-up any one, I just need an excuse to admire my neck again...

Laugh with me.

Jeff has cuter, curlier collaterals than either of us, Jugular.