Friday, January 15, 2010

Doppler, MRV and Venography - When, why?

An Italian TiMS reader who can't get her CCSVI assessment done in Italy (how ironic - apparently there are some kinds of "political problems") posted this concise and darn clear description of the various methods for assessing veins:
Just to clarify the differences of exams and definitions:

1.Eco-color doppler of extra-endocranical veins (in particular azygos and jugular veins are checked, since most commonly blood flow problems found there for MS.). The machine is a standard doppler machine as used for cardiovascular examinations (only that there they generally check arteries), and for the CCSVI test applied to MS patients a specific computer program is required and the examiner needs to know precisely which veins to look at.

2. MRV => Definition: The type of magnetic resonance imaging (MRI) used to visualize veins, the blood vessels that bring blood from the body's internal organs back into the systemic circulation.
The MRV uses the same machine as an MRI, but a special computer software allows it to only extract generated-by-blood images, as it flows through the veins. These images give doctors a rough idea of whether blood flow through a vein of interest is affected by blood clots or other disease processes.

=> Both 1+2 can either be separately or in combination used for a first CCSVI diagnosis. Zamboni used No 1.

3. Angiography - am confused about definitions on this term (I first thought called Venography), but seems that Simka is using an invasive technique to check the veins from inside in more detail? I understand that it is performed after diagnosis to check then the specific affected problem veins, to give more precise details on those, which are required for a following vein intervention.

4. The intervention process to eg enlarge the veins and potentially place some stents.

=> Simka does them all 4 one after the other to get a full picture. But for diagnosis only - to know if you have CCSVI - one of the 3 first should be sufficient.


 So, still a bit of confusion, but otherwise very helpful.

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