This Is MS Multiple Sclerosis Community: Knowledge & Support

If there is ANY chance of coming up with an "easy reader" version Dr Zamboni had better do it quick because there will be a very obvious time frame in which organized science will give up on CCSVI and with or without merit, if results are not replicable within reasonable effort and knowledge, CCSVI will be resting with the Titanic.

That ultrasound is quite specific. The Doppler is quite relevant and the images need to be taken in just the right way, otherwise the diagnosis is unclear.

Erica, the PhD who works with paolo, is phenomenal. She is very experienced at finding the veins and making pictures that are clear, unquestioned and sensible.

She starts with the right side of the neck in the lying down position. She does the doppler of the jugular vein in three areas J1 near the clavicle, J2 near the thyroid, and J 3 above the carotid bifurcation. She looks to see the direction of flow in each area. she images transversly. This shows the carotid and the jgular simultaneously. The color is supposed to be red and blue.....one going toward (IJ vein) and one going away (carotid) from the heart. Showing the two vessels together makes it very clear that they go in opposite directions if normal. Patients have sent me many images where the vein is seen in profile, but alone. cant figure out flow direction like that.

ok. after looking at the IJV at the three areas, she looks for the vertebral vein and artery. again, the two vessels are imaged together and the colors should be opposite.

Great, then she has the patient take a big breath which allows the veins to distend. she measures the cross sectional area of the jugular in its largest dimension.

Then she does a transcranial doppler looking for the deep cerebral veins. (this is the part i find the most difficult) She is looking for reversal of flow. that is always abnormal.

Finally puts the Bmode on and looks at the anatomy, looking for webs, stenoses, valves, etc

THEN She does everything again, in the upright position.

THEN, she does everything on the left side in just that order.

This study is quite challenging to learn. My colleage dan zinn finally got it. just by watching a few cases. It is not necessarily the most difficult but it certainly is quite specific and doing it wrong is going to lead to failures

As I was saying, I have reviewed a lot of studies done around the world. For the most part , they suck. when you get half the views, or the wrong manuevers, one is left with the distinct impression that you have no idea what it all means.

So it is clear that we need to create a standard. that standard needs to be specific, reproducible and simple.

by the time i learn this one, paolo may have perfected a US test that is easier to do with similar reliability.

no, he is really trying to validate it. He is not ready to publish



a standard should be evidence based, practical and reproducible. It should be inclusive but with high expectations. It should be reviewable, and available. It should be by consensus.



yes

Now folks this is coming from a layman when it comes to the vascular system but for the devastation this disease causes should it really be that hard to find the abnormalities? I mean if a blockage causes blindness, paralysis, etc. should it be that difficult to locate? I mean we are talking some serious damage to the nervous system not your run of the mill hand numbness.

Sorry, you're quoting scripture to atheists (of course that's a figure of speech).