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What is better, dopplar ultra sound or venogram, it is so bewildering to me these days. I thought venogram is the gold standard?

thornyrose76 wrote:What is better, dopplar ultra sound or venogram, it is so bewildering to me these days. I thought venogram is the gold standard?

venography is the gold standard. doppler is a screening and followup test that is cheap and noninvasive. helps me decide whether treatment is appropriate

thornyrose, do you mean catheter venogram (done as part of the procedure) or MRV venogram? The terminology is confusing. As our good doctor has said, catheter venogram is the gold standard. Ultrasound should be sufficient to give indication to do the catheter venogram. If ultrasound does not show CCSVI, perhaps then the more expensive MRV should be considered. Considering you are from Canada and it would be out-of-pocket, it might be nice if whatever doctor you end up with will not require an mrv.

I was talking MRV, yeah it is confusing! But is dopplar ultra sound sufficient? Can this look at azygous, it can't can it? What is usually charged for MRV?

But, if I have a dopplar ultra sound and then have catheter venogram, any blockages found in my body, meaning those found in azygous an d jugulars will be fixed correct? Sorry, my worried mind.

http://www.thisisms.com/ftopicp-139855.html#139855

drsclafani wrote:the doppler measures hemodynamic effects of abnormal venous return from the spine and brain. Abnormal doppler has been shown to be associated with azygos flow. Not to say that the doppler images the veins of the spinal cord anatomy. rather it measures the hemodynamics.

I haven't accepted this 100% though because how could abnormal flow caused by the azygous show up in the doppler up at the neck?

Yes, as part of the procedure during the catheter venogram, when something is found, the catheter is swapped out for a balloon catheter and it is thoroughly ballooned.

catheter venogram will show both, then? SHow everything?

Personally I am a fan of catheter venogram with IVUS, as done by drsclafani, for showing everything.

But yes catheter venogram as part of the procedure will be done of your azygous and jugulars and, depending on the skill level of your chosen IR, he'll find most or all of your CCSVI malformations.

That clears things up for me! Thanks Cece and Dr.!

Hello thornyrose76,
All techniques should come with the warning that they are as good as the Vascular Surgeon/Interventional Radiologist performing the procedure. I went to Athens for my catheter venogram and the VS found four stenosed veins (as many as anyone at that time) and took over 3 hours. Problems with values are also being found so many veins and valves need to be checked. So far there is no list of which veins to check, let alone the best method to de-stenose them.

Six months on de-stenosis was worth it, even if more veins/values need checking/treating in the future.

MarkW

Food for thought, thanx!