Document Detail

Screening for chronic cerebrospinal venous insufficiency (CCSVI) using ultrasound--recommendations for a protocol.
MedLine Citation:
PMID:  22233619     Owner:  NLM     Status:  MEDLINE    
Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenoses or obstructions of the internal jugular and/or azygos veins with disturbed flow and formation of collateral venous channels. Studies using ultrasound in patients with multiple sclerosis (MS) have demonstrated a high prevalence of CCSVI (mean 70%; range 0-100%; N.=1496), whereas, in normal controls and patients without MS the prevalence was much lower (mean 10%; range 0-36%; N.=635). Ultrasound uses a combination of physiological measurements as well as anatomical imaging and has been used for the detection of CCSVI by different centers with variable results. A high prevalence ranging from 62% to 100% of obstructive lesions has been found by some teams in patients with MS compared with a lower prevalence of 0-25% in controls. However, absence of such lesions or a lower prevalence (16-52%) has been reported by others. This variability could be the result of differences in technique, training, experience or criteria used. The current lack of a methodology shared among experts is a confounding element in epidemiologic studies, and does not permit further Bayesan or other kind of analysis. In order to ensure a high reproducibility of Duplex scanning with comparable accuracy between centers, a detailed protocol with standard methodology and criteria is proposed. This is also necessary for training. It has been shown that inter-rater variability increases post-training (from k=0.47 to k=0.80), while within-rater reproducibility in trained operators was k=0.75. Finally, the consensus document proposes a reporting standard of Duplex measurements, and future research to answer areas of uncertainty.
P Zamboni; S Morovic; E Menegatti; G Viselner; A N Nicolaides
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Publication Detail:
Type:  Consensus Development Conference; Journal Article; Practice Guideline; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International angiology : a journal of the International Union of Angiology     Volume:  30     ISSN:  1827-1839     ISO Abbreviation:  Int Angiol     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-01-11     Completed Date:  2012-05-08     Revised Date:  2012-05-10    
Medline Journal Info:
Nlm Unique ID:  8402693     Medline TA:  Int Angiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  571-97     Citation Subset:  IM    
Vascular Diseases Center, University of Ferrara, Ferrara, Italy.
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MeSH Terms
Azygos Vein / physiopathology,  ultrasonography*
Cerebrovascular Circulation
Cerebrovascular Disorders / epidemiology,  physiopathology,  ultrasonography*
Chronic Disease
Collateral Circulation
Constriction, Pathologic
Jugular Veins / physiopathology,  ultrasonography*
Mass Screening / methods*,  standards
Multiple Sclerosis / epidemiology,  physiopathology,  ultrasonography*
Observer Variation
Predictive Value of Tests
Reproducibility of Results
Spinal Cord / blood supply*
Ultrasonography, Doppler, Color
Ultrasonography, Doppler, Duplex* / standards
Venous Insufficiency / epidemiology,  physiopathology,  ultrasonography*
Erratum In:
Int Angiol. 2012 Apr;31(2):201

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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