Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands.
PLoS One. 2013 Nov 19;8(11):e78166. doi: 10.1371/journal.pone.0078166. eCollection 2013.
A new treatable venous disorder, chronic cerebrospinal venous insufficiency (CCSVI), has been proposed in patients with multiple sclerosis. The natural course of CCSVI has not been examined yet. This is crucial given the fact that surgical procedures are increasingly offered to MS patients to treat venous stenosis.
To document the natural course of venous haemodynamics we performed extra- and transcranial echo colour Doppler (ECD) in 52 multiple sclerosis patients and 28 healthy controls (HC) and re-examined this group after a median period of 16 weeks. The reexamination was done being blinded to the initial findings and the patients did not undergo any intervention.
The ECD examination at baseline showed CCSVI in 5 (9.6%) of the 52 multiple sclerosis patients and 0 HC (P = 0.26). At follow-up the diagnosis CCSVI could not be reconfirmed in 3 out of 5 patients at follow-up, while 2 new CCSVI-positive multiple sclerosis patients were detected.
ECD examination shows a fluctuating natural course of the extracranial venous haemodynamics, which makes determination of CCSVI by ECD examination unreliable.
一种新的可治疗性静脉疾病，慢性脑脊髓静脉功能不全（CCSVI），已在多发性硬化症患者中提出。CCSVI 的自然病程尚未得到检查。鉴于手术程序越来越多地提供给 MS 患者以治疗静脉狭窄，这一点至关重要。
为了记录静脉血液动力学的自然病程，我们对 52 例多发性硬化症患者和 28 例健康对照者（HC）进行了颅外和颅内经颅彩色多普勒（ECD）检查，并在中位时间为 16 周后对该组进行了重新检查。重新检查是在对初始结果不知情的情况下进行的，并且患者没有进行任何干预。
基线时的 ECD 检查显示 52 例多发性硬化症患者中有 5 例（9.6％）和 0 例 HC 存在 CCSVI（P=0.26）。在随访中，有 3 例随访患者中的 CCSVI 无法重新确认，而有 2 例新的 CCSVI 阳性多发性硬化症患者被检出。
ECD 检查显示颅外静脉血液动力学呈波动自然病程，这使得 ECD 检查确定 CCSVI 不可靠。
