Our champion lurker, fellow MS'er and one STELLAR hockey fan from the Great White North, has bequeathed to me the honor of displaying her "failed" MRV with you all, as an example to poke, prod, digest, dissect, discuss, or just gawk, and yes, she has a GOOD sense of humor. (Glam Shot Alert:any scouts out there please contact her agent)
Anna took a trip as many Canadians have, to just over the border to Seton Imaging in Buffalo, which many in here are already familiar with.
do keep in mind, it is my contention that the pathologist, along with the imaging center, made a truthful and professional assessment of the scan
, and that cannot
be overstated. This is not a "gotcha" moment here, it is just talking, looking, and discussing with each other. On first blush, the scan appears to be perfectly normal, and the pathologist was doing what they must, reporting "no obvious stenosis", and there isn't!! (Any obvious) It goes without sayng, we want our diagnostic centers/hospitals, to vigorously pursue excellence. If there's a chink in the armor, we'd like them to assess and improve their learning curve, not just blithely insist that "good is good enough". (Not insinuating Seton had that attitude by any means)
But, others might tend to disagree with that statement too. (Yes, I disagree, as a layperson with zero medical training FWIW, and one who is "biased" towards the CCSVI model, nuff said)
As a second caveat, let it be known that our dear Anna is very interested to get 2nd, 3rd, 4th, or as many PROFESSIONAL opinions from qualified individuals in the related fields, and will take whatever action she is going to take, based upon that, (along with her consulting physician
) and not anything you or I or anyone else on the internet will say.
Just wanted to make that crystal clear
for posterity, and to encourage our newer ones , or those who've received scans in the negative column, that the story does NOT end there, it is NOT the end of the world, and when the UT techs and equipment get up to speed, when the universities, hospitals, and clinics get trained, equipped, and are prepared to adequately deal with the onslaught of MS patients that are coming, then things will get better.
Some, of course, don't have that luxury, and some are very curious and don't mind spending the $ to get the scans, I know I would in a hot second, some have the luxury of time to wait for studies or other forms of subsidizing the cost of getting evaluated, everyone is in a different boat here.
That being said, let er rip. (REMINDER: KEEP AN EYE ON THE "L" OR "R" ON THE PICS, THAT TELLS YOU WHAT SIDE OF THE BODY IT IS ON!)
Here is the MRV COR shot: (Cor="Coronal")
TO VIEW LARGER SIZE
This is the MRA (A=Arterial) TOF shot (TOF=Time Of Flight).
TO VIEW LARGER SIZE
While MRV (Veins) is more desirable, some places toss it all in the same boat, and catch it (the contrast dye) going UP the arteries then DOWN the veins.
Interesting how Dr. D and others are finding that the right side on many individuals is the "dominant" side for flow. Wonder if that has to do with years of sleeping on that side? Don't laugh, might not be far off! If you look at scans of children that are online, their veins look very symmetrical. Shrug. Toss in the debate pile.
Okay on to a shot from the LEFT side, the MRV TOF, (but the Right is still visible, will put a combo shot up last) looks like a bunch of veins stacked up on each other, plus with the S shaped vertebral arteries in the middle. This is one of the drawbacks from my POV, in that there's so many vessels stacked up on each other, in PRECISELY the rotational view that you need to see the bend where the jugs go in and down, that the "good part" gets lost in all the noise. (And yet another good reason to NOT get an MRA)
On the axial shot (on the right), you can see the apparent
stenosis, facing towards the back of the head at nearly a 45 degree angle. And you will also note, that it is right at the level of the lower part of the ear, where many other stenoses have been found to date.
But, when rotating the TOF series to get that same angle of view, everything else is then in the way, hence our "lost shot". Hope that makes sense. That corner where they drop is where I'm putting all my money at this point. Later on will put a more detailed "blown up" version of this picture, as I believe it is telling.
TO VIEW LARGER SIZE
Once again, another combination shot, this time the Coronal view (on the left), compared with what is seen from the "bottom up" for that same area on the axial view. Too bad we can't get that coronal on a 45 eh? It just might show that narrowing light up like a Christmas tree.
FOR LARGER VIEW
Lastly, I wanted to zoom in and rotate the 3rd picture, to illustrate what I mean by viewing from a 45 degree angle. I rotated the MRA TOF shot to show the R/L IJV's more distinctly, sacrificing a bit of what appears to be the view of the narrowed portion (right where it dives down), and correlating that view to what you might see looking at it from the side on the axial.
FOR LARGER VIEW
Well that's about it for now, sure would welcome comments or criticisms. There's more to come on this scan in the future, as it will be reviewed by "the pro's" and will post up their assessments, good bad or otherwise.
Enjoy. Thanks to Anna for allowing us to look inside her head
Mark. (Who reserves the right to be W*R*O*N*G)