This Is MS Multiple Sclerosis Community: Knowledge & Support

OK...let me try to make this a bit more palatable.
MRV can give us flow quantification and perfusion information (which is good to have.)
It can also show us the "architecture" of the veins and collaterals.
Doppler can give us intraluminal defects and valve malformations, as well as refluxive flow.
Transcranial doppler gives us a picture of the deep cerebral veins.
Together, they make a terrific way to LEARN about CCSVI,
but not to DIAGNOSE CCSVI.
Diagnosis is really still done the best with doppler and TCD, using the Zamboni protocol.

When Jeff was diagnosed with CCSVI, there was no doppler tech at Stanford who understood Zamboni's technique and there were no TCD machines, so Dr. Dake used the technique he understood, MRV. Now, almost 3 years later, there are doppler techs at Stanford trained in the Zamboni protocol !!! MRV was all that was available, and in Jeff, it showed stenotic veins, collaterals and reduced flow.

Once Stanford announced they were doing MRVs at the Bologna conference, the other US groups wanted to publish about it...let's call it healthy competition. Dr. Zivadinov told me he thought BNAC was the only group looking at MRV. He was surprised by Dr. Dake's presentation. Then Dr. Haacke came forward with his protocol. This is how science moves forward...yes, it is confusing, and conflicting. But it is also illuminating.

The doctors get together once a year to go over all the data, gleen what they can from it, and improve the protocols. And what they are saying is that both MRV and doppler together provide the best overview. But obviously, these machines and protocol are not going to be available in every clinic around the world...so, the protocol will need to be refined, simplifed, further elucidated.

Check out the science program...it was just updated. Most of the conference is about coming together to establish protocols in diagnosis, treatment and aftercare. These docs are working (and publishing) as quickly as they can, but this is happening in real time.
http://www.isnvd.org/files/ISNVD%202012 ... 0(BROCHURE)-1-3-12-(PUBLIC%20v2).pdf
cheer

_________________
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
dual stents placed 5/09
CCSVI in MS

http://tinyurl.com/87vmjp8

(the link for the isnvd science program)

I only read the abstract, but how can there be an arterial/venous flow rate mismatch, unless the head is absorbing or generating blood? What goes in must come out.

I think I understand. Flow rate varies as the heart pushes the blood harder and less hard during contraction and relaxation of its muscle. That means acceleration and deceleration of blood, and increase and decrease of pressure as it moves. When you talk about a flow rate, that is really an average of all the different rates. The peaks are what is mismatched. The average in is equal to the average out, over a constant number of cycles, or heartbeats. For flow to be mismatched you have to be talking about instantaneous rates, but over an integral number of heartbeats covering equal amounts of in-time and out-time the average rate in=rate out. But maybe he calculated based on a peak number averaged over a number of people.

That is what Dr. Haacke is talking about when he says: "the flow has to double in the 2nd half of the cardiac cycle and becomes 20 cm per second in order to get it out". What goes in must come out. And by the time the heart reaches the beginning of the next beat (perhaps averaged over more than one)..

_________________
"Try - Just A Little Bit Harder" - Janis Joplin
CCSVI procedure Albany Aug 2010
'_MS' is over - if you want it
Patients sans/without patience

https://www.facebook.com/notes/ccsvi-in ... 5971522211

Slow blood flow, virusses stay longer at the same location....blood flow rate again
So, imo a definition of healthy ml/s blood flow range should be a 'must' to establish a proper diagnosis...and then look for causes (narrowings etc)

Measuring flow rate (average or peak) may only be possible if you standardize Dr. Haacke's "protocol" (which as cheerleader points out, is not so much a CCSVI diagnostic as Dr. Zamboni's 5 criteria using Doppler), and make it a standard treatment tool, as Dr. Hubbard has done, recognizing that every case of CCSVI is different, due to its genetic component. (How did Doepp do it?) Standard, like the IVUS should be. You can't do an accurate flow rate measurement if you've got a catheter in the vein. It's fuzzy whether it is necessary to diagnose. Even pressure is subject to Heizenberg-type problems. Maybe there is a way of doing it without an MRI. I think there isn't a huge rush to get the catheter in, once you have the CCSVI assessment, and an MRI (perhaps also looking at iron deposits) is helpful. It may be the only option to get to the bottom of the problem. Just as IVUS is, expensive but necessary. Maybe not so much in the future, when CCSVI is universally recognized, and treated early, and a lesser number of us have progressed into disability. But a good way of assessing average flow is a good thing, so lower-Tesla MRI machines may need to be used. As Dr. Haacke points out, they are useable, given the needed software, as may not be the case with assessment of iron deposits, or even full 3-D views. The 4-D might be the only option for flow rate. Though you might not need a graph, more information is always better. And as he says, it's quick and cheap compared to buying better MRI machines, or a full 3-d view, because maybe you only need neck slices. A lot of people will be having MRIs anyway, though it gets to be a lot less frequent, after "diagnose and adios". As we boomers age, health care gets very expensive. It's not our fault medicine and science are getting smarter, though. The people after us will be glad they did.

_________________
"Try - Just A Little Bit Harder" - Janis Joplin
CCSVI procedure Albany Aug 2010
'_MS' is over - if you want it
Patients sans/without patience

Cheer, you need to change the title of this thread. Every time It comes up I read the heading as "paperless" blood flow a couple of spaces before and after the "-" might help me.

I have been working in an office too long.... maybe I am beyond help.

BWAHAHA! Wow...once I read it like that, that's all I can see.
Are you an editor, Cure? I'm changing it now, just for you.
xo,
cheer

_________________
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
dual stents placed 5/09
CCSVI in MS