Multigate Quality Doppler Profiles and Morphological/Hemodynamic Alterations in Multiple Sclerosis Patients.http://www.ncbi.nlm.nih.gov/pubmed/22475396
Venous echo-color-Doppler (ECD) showed that chronic cerebrospinal venous insufficiency (CCSVI) syndrome is related to multiple sclerosis (MS). Study aims were to assess interobserver variability in ultrasound evaluation of MS patients and to relate echo-markers to MS clinical symptoms and disability degree. 277 MS patients (117 men, mean age 43.05±10.04 years) admitted to the Neurology Department of Bari University General Hospital, underwent to clinical, Expanded Disability Status Scale (EDSS) evaluation, and to a cerebro-venous system ECD evaluation. Two operators re-evaluate 32 patients to calculate interobserver variability. McNemar test confirmed the procedure reproducibility between two operators (p=ns). Septa/membranes correlated with deep cerebral veins reflux [right: absence 16% vs 58% presence, p<0.0001; left: 26% vs 50%, p<0.0001]; their absence to Primary Progressive (PP) MS form [right: 11% vs 2%, p<0.001; left: 12% vs 2%, p<0.001]. Internal jugular veins (IJVs) reflux absence was in Relapsing-remitting (RR) form [right: 60% vs 74%, p=0.036; left: 56% vs 85%, p<0.0001] like hemodinamically significant stenosis [right: 57% vs 69%, p=0.033; left: 49% vs 73%, p<0.001] not present in PP [right: 11% vs 2%, p<0.001; left: 10% vs 3%, p=0.009]. A supine IJVs blocked flow was related to EDSS class [right: 4.8±1.5 vs 5.4±1.4, p=0.006; left: 4.7±1.6 vs 5.5±1.2, p<0.0001]; its absence was linked to RR [right: 60% vs 76%, p=0.016; left: 58% vs 79%, p<0.001]. ECD has an important value in MS patients with IJV anomalies detection and a good interobserver procedure reproducibility. MS is associated to CCSVI, although further studies are needed.