Please help me understand my doppler results

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

Please help me understand my doppler results

Postby catlady » Thu Dec 02, 2010 6:07 am

I paid for this test, and I have a copy of the doppler images and the test report, but I do not understand what it means. Can someone help me, or direct me to information that explains these reports.


Specifically, does a 2/5 ccsvi criteria rating indicate that the blockages are minor?
How is it possible that my Right IJV is 7.2mm and the left is 39.2mm? That is such a big difference!


Supine
Right IJV cross sectional area: 7.4mm^2
Left IJV cross sectional area: 39.2mm^2
- Intermittent retrograde flow in the J1 segment of the right IJV and
the J1 and J2 segments of the left IJV.
- Intermittent absent flow in the J2 segments of the right IJV.
- Normal antegrade flow in the vertebral and deep cerebral veins.

Upright
Right IJV cross sectional area: 3.6mm^2
Left IJV cross sectional area: 2.5mm^2
- Intermittent absent flow in all 3 segments of the right IJV and the
J2 and J3 segemnts of the left IJV.
- Normal antegrade flow in the vertebral and deep cerebral veins.
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Postby TMrox » Thu Dec 02, 2010 6:11 am

Catlady, you might also want to put your question in Dr Sclafani's thread. He might be able to help.

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Diagnosed with Transverse Myelitis in December 2008. Inflammatory demyelination of the spinal cord (c3-c5). No MS, but still CCSVI.
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Postby Donnchadh » Thu Dec 02, 2010 6:49 am

Having 2 out of 5 possible kinds of venous abnormalities means that you have CCSVI per Dr. Zamboni's criteria.

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Postby catlady » Thu Dec 02, 2010 7:00 am

Donnchadh wrote:Having 2 out of 5 possible kinds of venous abnormalities means that you have CCSVI per Dr. Zamboni's criteria.

Donnchadh


Do you know where I can find the criteria?

How do I know which 2 criteria I have 'met'?
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Postby Cece » Thu Dec 02, 2010 7:16 am

one of the criteria is reflux or retrograde flow, where the blood flows back toward the brain, which you have here:
- Intermittent retrograde flow in the J1 segment of the right IJV and
the J1 and J2 segments of the left IJV.


Check the Dr. Sclafani thread index (it's a sticky by AlmostClever) and search for "doppler"?
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Postby Kleiner » Thu Dec 02, 2010 7:20 am

catlady wrote:
Donnchadh wrote:Having 2 out of 5 possible kinds of venous abnormalities means that you have CCSVI per Dr. Zamboni's criteria.

Donnchadh


Do you know where I can find the criteria?

How do I know which 2 criteria I have 'met'?



Catlady,

Here is my full report translated by Dr. Sclafani. It explains everything very well and you should be able to use the information to make sense of yours:


drsclafani wrote:
Kleiner wrote:Dr. Sclafani,

I posted this under it's own topic but was wondering if you could offer any insight/interpretation into the results I received from my Ultrasound. I am having trouble finding anyone around my location that can put it into english for me. Here is the original post:

http://www.thisisms.com/ftopict-14377.html

Thanks in advance for your assistance.


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.

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]
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Postby drsclafani » Thu Dec 02, 2010 11:21 am

Kleiner wrote:
catlady wrote:
Donnchadh wrote:Having 2 out of 5 possible kinds of venous abnormalities means that you have CCSVI per Dr. Zamboni's criteria.

Donnchadh


Do you know where I can find the criteria?

How do I know which 2 criteria I have 'met'?



Catlady,

Here is my full report translated by Dr. Sclafani. It explains everything very well and you should be able to use the information to make sense of yours:


drsclafani wrote:
Kleiner wrote:Dr. Sclafani,

I posted this under it's own topic but was wondering if you could offer any insight/interpretation into the results I received from my Ultrasound. I am having trouble finding anyone around my location that can put it into english for me. Here is the original post:

http://www.thisisms.com/ftopict-14377.html

Thanks in advance for your assistance.


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.

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]


that was a great illustration, thanks for reminding me of that one :wink:
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