Yes, less than stellar findings, which will be used by some to toss the baby out with the bathwater. MRV's are MRV's, just another tool, with it's own limitations. At first, the non-Zamboni-Doppler methods of screening were what was available at the time. We knew going into this, long ago, that without some type of transcranial doppler US readily available, with techs that knew what they were looking for, that the only avenues would be MRV, or the much ballyhooed "gold standard", which has it's own limitations.
While MRV may or may not show anything of diagnostic value, it is something that is readily available nationwide, presuming the proper Haacke/3.0 protocol is used, or even the Dake 1.5T protocol which I posted online some time ago. Sure, in a strictly scientific sense, we'd all love to just make an appt., wheel into the op room, get a "gold standard" venogram and be done with it.
Reality is not quite that simple, and while the above advice to "just go for the venogram" is spoken almost as an afterthought to the uninitiated both here and on FB, truth is, unless you have a bank account that can handle the above, or insurance that will just go for the venogram as a diagnostic tool, most people will be left out in the cold without
some thing to put on the paperwork so insurance will pay for it in the first place.
Yes, some are able to just wheel right in, especially the cash paying customers, but lets talk rubber meets road not the smattering of cases here and there, most people don't pay cash, most won't find an IR to "just go for the venogram", and most won't have insurance that will readily pay for investigative invasive procedures.
So yes, two choices are available for screening, MRV, or US. The US may, or may not show anything, depending on the person, the location, the equipment, the operator etc etc. There's over 700,000 people with MS just in the US and Canada, and only so many experience Dr's to go around, and, when this eventually hits the national news cycle here, watch out. I don't look at MRV as the be-all-end-all of all things diagnostic, it has it's limitations, but it can be the invitation to the party, and one thing that can prop the door open to the venogram, it's just a tool and nothing else. There's an MRI machine on every corner practically, they aren't difficult to find. The Haacke protocol (
http://www.ms-mri.com/potential.php) isn't either. Nor the Dake protocol (
which can be used on the 1.5T which is the most common in America. No, it's not perfect, no, it's not going to satisfy all that the scientific community requires, not even close.
To try to equate this study to one's personal situation is comparing apples and oranges. So you may, or may not bring something away from this, but for the average patient who just wants to find out what is "going on in their head", this has much less impact, though it will be used far and wide to downplay CCSVI in MS, whatever, so the MRV's aren't all that great vs. normals. That writing was on the wall from Buffalo since last year, no big shocker at all.
Suddenly though, if you are staunchly anti-ccsvi, this will be the "proof in the pudding", and the MRV will become of such great weight, why, how come we didn't see before that all this nonsense about CCSVI was just that?
Then, when the DBPC trial results begin to come in from Stanford, we'll hear of "conflicting results from two universities" because the layperson reading about this for the first time won't know all the history behind it.
Make no mistake about it though, while last year could be considered the tip of the iceberg, this year will be a watershed year, both in accumulation of knowledge from various sources esp Dr. Sclafani etc etc, and in elevation of CCSVI to a point where it belongs, IMO, at the front of the line insofar as it relates to PWMS and their immediate needs. No, CCSVI and it's treatment is not going to fix all that ails us, and no, it's not going to be for everyone.
Interesting times getting more interestinger.
