MRV - aren't they all the same?

Sharon · Post by **Sharon** » Sat Dec 26, 2009 11:50 am

jenf wrote

Yes, I just asked if they had a 3d machine... They were obviously a little confused and kept asking if I meant 3T. Not sure what the differences are; I have NO medical background what-so-ever

A bit of an explanation:
3T refers to the machine (T is for Tesla)

Tesla (T) is the unit of measurement quantifying the strength of a magnetic field. Prior to the 3 Tesla Machine, the high-field standard was 1.5 Tesla. A 3T machine generates a magnetic field that is twice the strength of 1.5 Tesla machines and 10 to 15 times the strength of low field or open MRI scanners. The magnetic field produced by a 3T yields exceptional anatomic detail. The increased image clarity revealed by 3T is particularly beneficial for pathological conditions involving the brain, spine, and musculoskeletal system.

That being said, Dake used a 1.5 Tesla for my MRV and MRI this was in June when he first started the testing. My daughter had her images on a 3.0 Tesla in the month of September.

2D or 3D is the dimensional field - obviously 3D is going to give a clearer rotational picture than a 2D. My MRV was performed using 2D time of flight technique.(also true for my daughter). 4D coronal flow sequences were also performed on my daughter.

The interventional radiologist is key to getting the results read correctly. There have been TIMS members who had testing completed and analyzed and were told the jugular veins were okay. Those people sent their CD images to Dake and he found the stenosis. I cannot remember who the members were --- maybe they will read this and comment.

Hope this helps
Sharon

Sharon · Post by **Sharon** » Sat Dec 26, 2009 12:05 pm

Just another thought ----

Haacke is using a specialized software (SWI) to look at the iron deposition in the brain. This software does not need to be used for the MRV --- Dake did not have this software when he did our MRI/MRV.

Dake has modified the imaging sequences and software since he started with his first patient (May 2009). I know that on my follow-up testing in August, there were different sequences than when I was first seen in June.
The docs have to know what they are looking for.

Sharon

ozarkcanoer · Post by **ozarkcanoer** » Sat Dec 26, 2009 1:05 pm

Sharon,

Everything I have read on this board makes me want to wait for Dr Haacke's study and to NOT just get an MRV here in St Louis ! It was so depressing when my imaging by Dr Haacke got postponed from December 7th to who knows when. But I know he is under a lot of pressure so I will bide my time and rest assured that I will get scanned by Dr Haacke.

ozarkcanoer

bestadmom · Post by **bestadmom** » Sat Dec 26, 2009 1:54 pm

I had the MRV done on a 3T at SUNY Buffalo and it is not in 3D. An interventional radiologist in NYC read the disk as a favor and saw stenosis, and plenty of it. Another radiologist at a different hospital took a look at ths this week and saw nothing.

Marcstck had a CT scan, I believe, and the radiologist saw nothing. Then a family friend who is head of radiology at another hospital saw stenosis on one jugular. Dr. Dake got the disk and I think he saw it on both jugulars. Seach his posts to be sure.

Bottom line is if there is any stenosis, a venogram must be done. That's when the interventional radiologist will see and know exactly where the occlusions are. The MRV is a basic diagnostic tool but is not a roadmap for fixing occlusions.

Sharon · Post by **Sharon** » Sat Dec 26, 2009 2:59 pm

bestadmom wrote:

Bottom line is if there is any stenosis, a venogram must be done. That's when the interventional radiologist will see and know exactly where the occlusions are. The MRV is a basic diagnostic tool but is not a roadmap for fixing occlusions

You are correct --- the venogram is invasive and probably would not be done until a planned procedure.

The problem, which you detailed, is that unless the radiologist knows what to look for, there is a very good chance a stenosis is going to be missed. Someway we need to get the imaging protocol, whether it be Dake's or Haacke's, available to the radiiologists.

OC - I think you are making a wise choice - you are fortunate to know that you are on Haacke's list to be called.

Sharon

mrsilkykat · Post by **mrsilkykat** » Sat Dec 26, 2009 5:14 pm

Talking about jugulars--are you talking external jugs or intenal or both?

mrsilkykat · Post by **mrsilkykat** » Sat Dec 26, 2009 5:22 pm

We live near Univ of Calif Med Center in San Francisco. If we can get our neuro to write a scrip for MRV with contrast, do we then call the Vascular Department, Interventional Neuroradiology or just plain radiology? Do we then tell them we want an MRV on a 3 Tesla and a 2d or 3d?

I am asking this question for a group of MSers.

Thanks

bestadmom · Post by **bestadmom** » Sat Dec 26, 2009 5:40 pm

My cousin is the head of radiologist/radiology professor at UCSF and came from Stanford and knows about CCSVI from me. He couldn't help me. He said to go for interventional radiologists. They know what to look for.

Sharon · Post by **Sharon** » Sat Dec 26, 2009 6:38 pm

Interventional radiologists -
If you have a choice, go for the 3Tesla
3D imaging is going to be clearer than 2D -

So much of this depends on what is available at the radiology center.

Sharon

mrsilkykat · Post by **mrsilkykat** » Sun Dec 27, 2009 12:07 pm

I'm still so new at this I don't know if we're talking about the internal or external jugulars. Just for clarification. Thanks.

Sharon · Post by **Sharon** » Sun Dec 27, 2009 12:51 pm

Internal jugular veins are what is being looked at in CCSVI

mrsilkykat · Post by **mrsilkykat** » Sun Dec 27, 2009 3:16 pm

Thanks, Sharon. I kind of figured that from looking at my Anatomy Coloring Book. ha ha.

In noodling through the TIMS threads, I found a photo of what I guess is an MRV complete with coded veins but I can't find it again. Does anyone know what I'm referring to & which thread it is in?

I can see I need to organize my research.

Thanks.

jenf · Post by **jenf** » Wed Jan 06, 2010 6:47 am

Mrsilkycat,
This may sound like a silly response, but are you referring to the image shown on the first page of this thread? If not, there's several others located in the "Identifying anatomy" thread....
Jen

mrsilkykat · Post by **mrsilkykat** » Wed Jan 06, 2010 9:20 pm

Jen,

Thanks for your "silly" response, which totally was Not silly. Yes, I was referring to the image on the first page. I get lost in here sometimes. TIMS FOG.

This is a valuable thread.
Thanks.

thisisalex · Post by **thisisalex** » Wed Jan 06, 2010 11:57 pm

I arranged an MRV in Hungary, but they tried to do an MRV of the brain only excluding the neck. I showed the Haacke protocol and they said it needs some configuration on the machine, but the doctor was interested in the idea to make it later...
so MRV-s are not the same

bring the protocol with you