Posted: Mon Nov 01, 2010 10:49 am
MRV < Doppler < Catheter Venogram < Catheter Venogram with IVUS or Catheter Venogram with Sinan's method of Azygous Diagnostic Ballooning
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Dr Haacke is working very hard to move MRV up in that ranking and where does fMRI (Dr Hubbard) fit in? or does it?Cece wrote:MRV < Doppler < Catheter Venogram < Catheter Venogram with IVUS or Catheter Venogram with Sinan's method of Azygous Diagnostic Ballooning
I'm not sure. Hmm. I'd say the ones I listed are all directly diagnostic for CCSVI either through structural imaging or hemodynamic flow measurement. Dr. Hubbard's fMRI measures the effects of CCSVI, by measuring the oxygenation or cerebral perfusion both pre- and post-procedure. But it's brilliant too.PCakes wrote:Dr Haacke is working very hard to move MRV up in that ranking and where does fMRI (Dr Hubbard) fit in? or does it?Cece wrote:MRV < Doppler < Catheter Venogram < Catheter Venogram with IVUS or Catheter Venogram with Sinan's method of Azygous Diagnostic Ballooning
teacha teacha teeeeach me.. Sorry, Halloween hangover
Venous backflow alias "Reflux in the brain" is a Bogeyman of CCSVI theory, monstrous imaginary figure used in threatening MS-patients. This legendary monster has no specific appearance, no evidence of existing, non explainable by any hemodynamic theory. He simply has no set appearance, but is just an amorphous embodiment of terror. Just endless repeating .... If you are not Liberated, the bogeyman will get you and eat your brain!Abstract
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Flow quantification showed no venous backflow in any MS patient or control.
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I've seen people here at thisisms try to add up ballpark figures but it's never been evident there are any trustworthy numbers on how many people have had venous angioplasty for CCSVI. Confounding the situation even more is the consideration that a good number of people have been treated more than once and it's essential to be differentiate "number treated" from "procedures performed".MarkW wrote: 2000 plus people have been de-stenosed after diagnosis with selective venography. This Dutch study is poor science and meaningless in size against 2000 real pwMS. Let's move on to real science not this rubbish.
Read Sclafani's paper on how to diagnose it you want to learn more.
I agree with your points about the Dutch study but it's also important to point out that, in kind, there isn't "real science" and only "rubbish" to compare it to.MarkW wrote:This Dutch study is poor science and meaningless in size against 2000 real pwMS. Let's move on to real science not this rubbish.
scorpion wrote:Jugular wrote:
Leonard said:
I think that some people may have stronger veins (more Vit D during their childhood/ their mother metabolised more sun during pregnancy?), veins that are less susceptible to microbleedings. so, maybe, some people will also have stenoses but do not develop MS for that reason.
Is this something that has been proven or is it a wild guess?
Leonard said:in any event, those with the weaker veins and MS benefit from liberation. that is the ultimate test! not whether other people happen to have stenoses and no MS.
Once again can you please let me know where you discovered that "those with weaker veins and MS benefit from liberation" Although there are some blinded studies in the woodworks, no one can make an ABSOLUTE claim about anything at this point.
thanks for the full paper, Sotiris. Even having spent time with Dr. Haacke discussing his protocol and time of flight 3D imaging and the reflux he is seeing, I am hard-pressed to find any problems with this study (except for the small sample size) I've forwarded to the good doctor and asked for his thoughts. I will post them if he OKs that.Sotiris wrote:The paper can be found here:
http://www.overcomingmultiplesclerosis. ... ntId=20084
(there is a small delay in displaying the pdf)
The pictures included were lovely, with gorgeous, open veins and nothing like the pics I've been seeing of MS patients from Dake and Haacke's MRVs. And not like Jeff's mangled jugulars and squirrelly collaterals at all....We have to be aware that all available standard imaging approaches for the evaluation of the cranial venous system represent rather a snapshot. The venous blood flow is influenced by many different physiological factors and their interaction such as respiratory changes, swallowing, central venous pressure, position of the patient (supine, sitting, upright), muscle contraction, etc. Regarding the analysis of the intracranial and cervical venous systems, it is almost impossible to take all of these factors into account, regardless of the imaging modality used.
this was posted yesterday in Dr. Sclafani's thread, it may help show how venous reflux is described in Doppler exams, I have bolded some relevant parts:Malden wrote:Venous backflow alias "Reflux in the brain" is a Bogeyman of CCSVI theory, monstrous imaginary figure used in threatening MS-patients. This legendary monster has no specific appearance, no evidence of existing, non explainable by any hemodynamic theory. He simply has no set appearance, but is just an amorphous embodiment of terror. Just endless repeating .... If you are not Liberated, the bogeyman will get you and eat your brain!
drsclafani wrote: 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
Cheer, you cheered me up for sure! I would really like to hear what Haacke has to say about this study. But you're right, from the figures, both the MS and control subjects in the study appear to have enviable veins.cheerleader wrote: The pictures included were lovely, with gorgeous, open veins and nothing like the pics I've been seeing of MS patients from Dake and Haacke's MRVs. And not like Jeff's mangled jugulars and squirrelly collaterals at all....
cheer
Pshaw! Do you call that a stenosis? I'll see your stenosis, and raise you two - a la Alligator Johnson (but not really).Jugular wrote:Cheer, you cheered me up for sure! I would really like to hear what Haacke has to say about this study. But you're right, from the figures, both the MS and control subjects in the study appear to have enviable veins.cheerleader wrote: The pictures included were lovely, with gorgeous, open veins and nothing like the pics I've been seeing of MS patients from Dake and Haacke's MRVs. And not like Jeff's mangled jugulars and squirrelly collaterals at all....
cheer
Perhaps the Dutch, even those with MS, are beautiful people with lovely veins???
I almost feel like saying, ala Crocodile Dundee, you're calling that a stenosis mate?
THIS is a stenosis.
Well, granted, Jeff's curly collaterals are quite fetching, but I would like to argue that the slim mid-section and barrel shaped upper body appearance to my RIJV would be quite attractive to the ladies. Well, come to think of it, it looks more like skinny legs and barrel shaped belly.Johnson wrote:Pshaw! Do you call that a stenosis? I'll see your stenosis, and raise you two - a la Alligator Johnson (but not really).
I'm not really trying to one-up any one, I just need an excuse to admire my neck again...
Laugh with me.
Jeff has cuter, curlier collaterals than either of us, Jugular.