AM I READING THIS CORRECTLY !!!

[MrSuccess]

MRI's are only about 98% accurate .

You can research that FACT ..... or ask a surgeon .

Why would MRV's be any less or more accurate ?





Mr. Success

[Cece]

Zamboni's paper:

Int Angiol. 2010 Apr;29(2):127-39.

Use of neck magnetic resonance venography, Doppler sonography and selective venography for diagnosis of chronic cerebrospinal venous insufficiency: a pilot study in multiple sclerosis patients and healthy controls.
Hojnacki D, Zamboni P, Lopez-Soriano A, Galleotti R, Menegatti E, Weinstock-Guttman B, Schirda C, Magnano C, Malagoni AM, Kennedy C, Bartolomei I, Salvi F, Zivadinov R.

The Jacobs Neurological Institute, State University of New York, Buffalo, NY, USA. rzivadinov@bnac.net

Abstract
AIM: Chronic cerebrospinal venous insufficiency (CCSVI) is a vascular condition characterized by anomalies of primary veins outside the skull that restrict normal outflow of blood from the brain. CCSVI was recently described as highly prevalent in patients with multiple sclerosis (MS), and can be non-invasively diagnosed by Doppler sonography (DS) and invasively by selective venography (SV). The aim of this paper was to investigate the value of neck magnetic resonance venography (MRV) for the diagnosis of CCSVI compared to DS and SV in patients with MS and in healthy controls (HC).

METHODS: Ten MS patients and 7 HC underwent DS, 2D-Time-Of-Flight venography (TOF) and 3D-Time Resolved Imaging of Contrast Kinetics angiography (TRICKS). MS patients also underwent SV. The internal jugular veins (IJVs) and the vertebral veins (VVs) were assessed by both MRV sequences, and the findings were validated against SV and DS. SV has been considered the diagnostic gold standard for MS patients.

RESULTS: All MS patients and none of the HC presented CCSVI, according to the DS criteria. This was confirmed by SV. For CCSVI diagnosis, DS showed sensitivity, specificity, accuracy, PPV and NPV of 100%, whereas the figures were 40%, 85%, 58%, 80% and 50% for 3D-TRICKS, and 30%, 85%, 52%, 75% and 46% for 2D-TOF in the IJVs. In MS patients, compared to SV, DS showed sensitivity, specificity, accuracy, PPV and NPV of 100%, 75%, 95%, 94% and 100%, whereas the figures were 31%, 100%, 45%, 100% and 26% for 3D-TRICKS and 25%, 100%, 40%, 100% and 25% for 2D-TOF in the IJVs.

CONCLUSION: The use of MRV for diagnosis of CCSVI in MS patients has limited value, and the findings should be interpreted with caution and confirmed by other imaging techniques such as DS and SV.

[1eye]

But MRI is very powerful! You are taking sliced up views, across a time window. That a particular trial could not find a particular thing with a particular MR technique says potentially zero about whether what you are looking for is actually there or not, and nothing about finding it with other means, MR or not. It may not be findable with those techniques, or with MR at all (I kind of doubt that). These conclusions are blown up and misinterpreted as required, depending on what is required.

[scorpion]

http://ccsvinews.blogspot.com/2011/01/n ... ffalo.html

Yes, you are reading correctly. In this case they were using MRV instead of doppler, and it has been reported several times to have low sensitivity. This article only confirms this point.

So what does this say about the Kuwait study? Didn't they use MRV? The criteria used in order to be approved for the procedure was" proven MS with positive Doppler and MRV (> 50% stenosis). "

[zap]

I may be over reacting but this guy from U of B continues to disappoint me as one who has said "Hey we are on your side"

G

You know, I've always had reservations about him, so these continuing developments are interesting to me.

A good article about Zivadinov here:

http://www.nacional.hr/en/clanak/38074/ ... usinessman

... my paranoid side gets worried about his reliance on big pharma dollars ... in my imagination it is plausible that those who stand to lose billions if MS is a vascular condition would organize a well-publicized study that is corrupt, with the goal of discrediting CCSVI in the public eye and burying it ...

Robert Zivadinov adds that clinical research is the most profitable area of work his Centre does. "We are a centre that reads the findings of magnetic resonances for multi-centre clinical research, which means that about 100 different centres around the world send us their magnetic resonance shots for our analysis. The analysis and research is done in collaboration with the world's largest pharmaceutical companies who provide massive funding for this kind of research, and that is one of the aspects of the financing of our centre. We currently cooperate with five pharmaceutical companies for whom we are working on five big clinical research programs." Zivadinov points out that pharmaceutical companies are in recent years exceptionally interested for research into mediations for multiple sclerosis. While there were in 2001, he says, only a few such companies, there are currently at least twenty that are launching research linked to multiple sclerosis.

Of course I am aware that this is pure paranoia at this point! (But if the Italian research looks positive, Dake's stent patients do good, but then this Buffalo study comes back negative, you can bet I'll be letting the paranoia come to the forefront of my mind. )

Fortunately, I am sure his center will find plenty of profit in workng with the intensive imaging/MRI requirements of this potential new paradigm ...

(from http://www.thisisms.com/ftopicp-71203-z ... html#71203 - October 2009)

[scorpion]

I may be over reacting but this guy from U of B continues to disappoint me as one who has said "Hey we are on your side"

G

You know, I've always had reservations about him, so these continuing developments are interesting to me.

A good article about Zivadinov here:

http://www.nacional.hr/en/clanak/38074/ ... usinessman

... my paranoid side gets worried about his reliance on big pharma dollars ... in my imagination it is plausible that those who stand to lose billions if MS is a vascular condition would organize a well-publicized study that is corrupt, with the goal of discrediting CCSVI in the public eye and burying it ...

Robert Zivadinov adds that clinical research is the most profitable area of work his Centre does. "We are a centre that reads the findings of magnetic resonances for multi-centre clinical research, which means that about 100 different centres around the world send us their magnetic resonance shots for our analysis. The analysis and research is done in collaboration with the world's largest pharmaceutical companies who provide massive funding for this kind of research, and that is one of the aspects of the financing of our centre. We currently cooperate with five pharmaceutical companies for whom we are working on five big clinical research programs." Zivadinov points out that pharmaceutical companies are in recent years exceptionally interested for research into mediations for multiple sclerosis. While there were in 2001, he says, only a few such companies, there are currently at least twenty that are launching research linked to multiple sclerosis.

Of course I am aware that this is pure paranoia at this point! (But if the Italian research looks positive, Dake's stent patients do good, but then this Buffalo study comes back negative, you can bet I'll be letting the paranoia come to the forefront of my mind. )

Fortunately, I am sure his center will find plenty of profit in workng with the intensive imaging/MRI requirements of this potential new paradigm ...

(from http://www.thisisms.com/ftopicp-71203-z ... html#71203 - October 2009)

Case closed than he must have altered the data! Anything he does in the future must be looked at suspiciously since he collaborates with pharmaceutical companies unless of course his results in some way validate what everyone wants to believe about CCSVI. Poor Zivadinov. From hero to dirty bird in one press release.

[zap]

just saying.

[Jugular]

These studies are focused on the IJV's and stenosis. They leave out valves and the azygous. They are bound to be unhelpful because they do not have a clear idea about what they are looking for.

CCSVI almost requires a reverse approach - find the best way to treat a problem and then develop best methods of detecting it. And then theorize why it all works.

We need clinical trials. To engage in anything else at this point seems to be generating nothing but confusion and adding fuel to a propaganda war.

[Cece]

It is too soon for clinical trials, it would be testing an instrument that is in the process of being built. Let them finish building the instrument first. It'll have a better chance of holding up. This is important, it should be done right.

zap, interesting....

[scorpion]

It is too soon for clinical trials, it would be testing an instrument that is in the process of being built[/b]. Let them finish building the instrument first. It'll have a better chance of holding up. This is important, it should be done right.

zap, interesting....

Than why are people getting treated for it????

[Cece]

It is too soon for clinical trials, it would be testing an instrument that is in the process of being built[/b]. Let them finish building the instrument first. It'll have a better chance of holding up. This is important, it should be done right.

zap, interesting....

Than why are people getting treated for it????

Because it currently seems to be "good enough", i.e., better than nothing but not as good as it could be.

In Dr. Sclafani's interview from awhile back, he talked about vaccinations as an analogue for this. They still did good and were worth having when they were first invented, but they performed better as they were refined in the years to come. CCSVI treatment needs to be refined or standardized or improved upon.

We also have Dr. Cumming who recently said that even a guide wire can cause intimal injury. How can we then justify the sham part of a sham trial, with no benefit to the patient and some risks?

But I am off-topic here, apologies! None of this is new, it's the usual disagreement.

[frodo]

http://ccsvinews.blogspot.com/2011/01/n ... ffalo.html

Yes, you are reading correctly. In this case they were using MRV instead of doppler, and it has been reported several times to have low sensitivity. This article only confirms this point.

So what does this say about the Kuwait study? Didn't they use MRV? The criteria used in order to be approved for the procedure was" proven MS with positive Doppler and MRV (> 50% stenosis). "

As far as I know, a positive MRV is just an indication that has to be confirmed later by invasive phlebography. According to this article, in Kuwait they have been using a bad indicator, but this does not invalidate at all the results of the study because problems were confirmed also by phlebography.

[se1956]

MS is a VERY SLOW disease, so the differences between MSler and healthy must be very small. If not, 5 year old children should show first MS symptoms.

The X-ray pictures in the early stages of breast cancer should be interpreted by two experienced independent doctors, because it's not an easy task.

Therefor all the results from Z. are quite conclusive and do NOT disprove CCSVI.

R.

[sou]

It is not that slow sometimes.

The CNS myelinates itself until around the age of 18. Until that time it has the capacity and ability to remyelinate any possible damage. However, even the normal appearing white-matter is not normal in pwMS. After myelination ends, the damage can not be easily overcome and then what we call MS occurs.

Could dysmyelination be due to chronic hypoxic conditions?

[Cece]

It's interesting, it's actually age 39 that we reach our peak amount of myelin in our brains:

http://www.ncbi.nlm.nih.gov/pubmed/18926601

RR often changes to SP around age 40 as well. I can hear the clock ticking....