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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2012 December;171(6):775-83
Chronic cerebrospinal venous insufficiency diagnostics
Grozdinski L. 1, Petrov I. 2, Iloska M. 1
1 Angiology and Phlebology Sector, Clinic of Cardiology and Angiology, Tokuda Hospital Sofia, Bulgaria;
2 Clinic of Cardiology and Angiology, Tokuda Hospital Sofia, Sofia, Bulgaria
AIM: The aim of this study is to examine frequency of CCSVI among healthy and Multiple Sclerosis (MS) patients using Color-Doppler and verify the relationship between CCSVI and MS.
METHODS: We have examined 178 patients. Gr. 0 - 40 patients without data for MS and Group A- 138 patients with MS. The ultrasound examination of the internal jugular veins (IJV) was performed using a Color Doppler. Selective venography was conducted only upon patients with positive results for CCSVI.
RESULTS: Group 0 - 10% had Doppler data indicating CCSVI, while Group A showed CCSVI data in 89 % of the cases. Venous reflux was determined in 73%, a reduced or lack of distal flow in 78%, and a lack of collapse reaction of the jugular veins in sitting position was observed among 71%. The relative risk of CCSVI amongst patients with MS is: RR 8.9. In all of these 123 patients (100%) with CCSVI data, stenosis in the IJVs and the azygos vein were found by venography. The IJV was stenosed in 88 % and azygos vein – 67 % of the cases. These data confirm the relationship between CCSVI and MS, and establish high sensitivity of Doppler diagnostics of IJV stenosis.
CONCLUSION: We have determined a high frequency of CCSVI among patients with MS. The ultrasound compared to the venography shows high sensitivity and accuracy for CCSVI diagnostics and it is a preferred method for non-invasive screening for CCSVI amongst MS patients.