new Serbian study finds CCSVI by ultrasound in pwMS

[Cece]

http://phleb.rsmjournals.com/content/27/4/168.abstract

Morphological and haemodynamic abnormalities in the jugular veins of patients with multiple sclerosis

Vascular Surgery Clinic, Dedinje Cardiovascular Institute, School of Medicine, Belgrade University, Heroja Milana Tepića 1 Street, Belgrade, Serbia

Abstract

Objectives
Multiple areas of stenosis and different levels of obstruction of internal jugular and azygous veins (a condition known as cronic cerebrospinal venous insufficiency) recently emerged as an additional theory to the well-known autoimmune concept, explaining etiology of multiple sclerosis (MS). The aim of our study was to evaluate internal jugular vein (IJV) morphology and haemodynamic characteristics in patients with MS and compare it with well-matched healthy individuals and to evaluate the prevalence of venous flow abnormalities in both groups.

Methods
Sixty-four patients with clinically proven MS and 37 healthy individuals were included in our study. In all patients, IJV morphology and haemodynamic characteristics were evaluated by colour Doppler sonography as well as venous flow disorder. The patients were classified into four groups according to MS clinical form presentation. The prevalence of morphological and haemodynamic abnormalities in the IJV were assessed.

Results
The presence of stenosing lesion, mostly intraluminal defects like abnormal IJV valves, were observed in 28 patients (43%) in the MS group, and in 17 patients (45.9%) in the control group (P = NS). By adding haemodynamic Doppler information in the IJV venous outflow was significantly different in 42% of MS patients showing flow abnormalities (27/64), as compared with 8.1% of the controls (3/37), P < 0.001.

Conclusion
In our group of patients, patients suffering from MS had significantly more IJV morphological changes and haemodynamic abnormalities when compared with healthy individuals not suffering from MS. These findings can be well demonstrated by non-invasive and cost-effective Doppler ultrasound.

[1eye]

In this study I take flow abnormalities to mean reflux, and stenosis to mean narrowing. This abstract does not give the overlap, which would in most cases result in a CCSVI diagnosis, nor does it include the azygus, which, as has been pointed out many times, is not tested with Doppler Ultrasound.

The problem with using Doppler Ultrasound as an all-or-nothing test for anything is that it is so operator-dependent. So the studies say more about the operators than they do about the patients, even if well-blinded. And there's always the absence of the azygus vein.