Conclusions:
1. No Stenotic flow- BIL. CCA, ICA, VA,SA
2. IJVVI, LEFT(+), No SOVR BIL.
3. Small Lumen Diameter(0.08) In Left Internal jugular veins, (0.15) in Right Internal jugular veins(左側內部頸靜脈管徑比右側內部頸靜脈小, 1/2)
4. Intermittently flow stop noted in Right Internal jugular veins (右側內部頸靜脈有間歇性的停止)
5. Flow detected in BIL. ACV, But paradoxically the flow in Left and Right side were decreased when Right Internal jugular veins was compressed, Left side compression showed normal response (在對右側頸部加壓時, 兩側頸靜脈的流量均反常的降低, 但對右側頸部加壓時並沒有流量降低的現象)
6. Clear Vessel wall - BIL, CCA
在BIL 和CCA的影像中其血管壁是很乾淨的?
以上誰知道BIL, CCA, ICA, VA,SA為何? 是指動脈嗎?
大家的結果如何呢?
曉昌, 若你看到的話, 可否比較一下?
發表文章
看無呢!!
回覆刪除第五點後面那句應是左側吧!
第三點是代表你的左測有問題嗎?
可是第四點是不是說你的右側有問題?
那是.....什麼????
這樣是可以去義大利開刀了嗎????
我的問題真多!不好意思!
怎麼不問醫生比較快!
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你好，很高兴看到你的检查结果。是的，CCA, ICA, VA,SA指动脉，
回覆刪除CCA= common carotid artery;
ICA= internal carotid artery
VA= vertebral artery
SA= splenic artery?
BIL 是缩写，表示双侧，（bilateral）
看来你还是有静脉狭窄，医生意见如何？你在哪里做的？
从检查结果来看，
回覆刪除你的动脉都没有问题，但是左侧颈静脉有狭窄（第3点），
第5点也提示左侧静脉有狭窄，正常情况下，压迫右侧静脉，左侧静脉流量应该增强，但是你的情况却反常降低。
仅代表个人意见。
我是在台灣台北榮民總醫院做的, 我個人也覺得有點不太正常,
回覆刪除1.（第3点和第5点）都顯示有異狀,
2, 報告中用了"paradoxically"反常 的字眼..
如果想进一步确定，可能需要做核磁共振血管造影比较好。
回覆刪除Dear Jimmy,
回覆刪除我今天去聽報告了
報告結果是...正常...@@
我在我的部落閣有寫整個經過,如果你想了解可以去看看
比較詳細喔http://dadastevenhuang.spaces.live.com/default.aspx
dada
美国斯坦福已经暂时停止手术，这是我收到的电邮：
回覆刪除Thank you for your inquiry regarding our work on blockages of the veins of the head and neck associated with multiple sclerosis. I wish I could talk with you personally to explain our ongoing work, but in order to provide a reply to all, I must respond by email. After careful review at Stanford, we have determined that the initiation of a clinical development program leading to a possible clinical trial will be the next step as we examine the possible risks and benefits of balloon angioplasty with or without venous stenting for patients with multiple sclerosis. This evaluation will start shortly but it is unlikely that, even given a highly positive outcome, we would be initiating any clinical trial before the second half of 2010 at the earliest. In light of these next steps, I am not currently performing the procedure at Stanford.
Please be assured that we will keep your contact information on file and provide appropriate updates of our work on this important issue.
I hope to have the opportunity to speak with you in the future.
Sincerely,
MICHAEL D. DAKE, M.D.
现在很多人到波兰去做手术，这是二兄弟去波兰的报道：
回覆刪除Evan Thornton, 49, is a busy community activist, online newspaper publisher and father. But MS has been slowing his pace. The condition has left him with numbness on the right side of his body, and his headaches and fatigue, common MS symptoms, have been getting worse.
Thornton says a new surgical procedure has given him hope. The treatment is based on the theory that MS is linked to chronic cerebrospinal venous insufficiency, a condition where blocked veins in the neck or chest prevent blood from draining properly from the brain.
Dr. Paolo Zamboni, the Italian vascular surgeon who came up with the theory, devised an experimental treatment similar to angioplasty, which involves removing the blockage in the veins that carry blood to and from the brain. Zamboni gained international attention after he published a study in 2009 that suggested the treatment was highly successful in reducing MS symptoms.
The surgery in Poland, based on Zamboni's work, will cost Thornton about $10,000. It's not covered under his health insurance, as the treatment is still being researched in North America. But some doctors overseas offer to perform it.
Thornton said he's not willing to wait for the surgery to be accepted by North American doctors.
"I'm turning 50 this year and this is a chance to start so many things again," he said.
Younger brother to make trip
Thornton won't be alone when he flies to Poland. His younger brother Duncan, who lives in Winnipeg and also has MS, will be going with him for the same procedure.
The 47-year-old Winnipeg author said the procedure presents a chance to lead a more normal life.
"I've got two little kids and I've got other books I'd like to write," he said. "There's a good chance I'll go on having mild symptoms for a long time, but it's an unpredictable disease."
Like his brother, Duncan is paying $10,000 for the surgery.
The MS Society of Canada has reacted to Zamboni's research with caution. In November 2009, the society said it would offer grants for researchers in Canada to examine the procedure's safety and effectiveness. In the meantime, the society urged people with MS to be patient and continue with their regular treatment, which often includes medication.
Canada has one of the highest rates of multiple sclerosis in the world, according to an international survey.
The 2008 Atlas of Multiple Sclerosis showed MS strikes 133 people out of every 100,000 in Canada, the fifth highest rate among countries surveyed between 2004 and 2005.
Read more: http://www.cbc.ca/world/story/2010/03/18/ott-ms-surgery.html#ixzz0iagN6Ak6
补充一下，斯坦福大学的手术暂时停止，并非否认手术，只是检讨如何提高手术安全，让手术更加安全成功。
回覆刪除另外，美国纽约已经启动一个大的MS病人的手术实验计划，这个项目的结果，以及其他国家的手术结果，将很快证明手术的成效如何。
一般静脉狭窄手术的原则是，静脉如果有50%狭窄，就符合手术标准。
这里是意大利医生手术治疗MS的报告摘要，网上有全文，英文好的人可以去读。初步看来，手术结果与MS类型有相当关系，RR型治疗结果最佳，其他类型效果有限。
回覆刪除Zamboni P. et al.:
A prospective open-label study of endovascular treatment of chronic cerebrospinal venous insufficiency.
Journal of Vascular Surgery - December 2009 (Vol. 50, Issue 6, Pages 1348-1358.e3, DOI: 10.1016/j.jvs.2009.07.096).
Presented at the Thirty-first Charing Cross Symposium, London, United Kingdom, Apr 3–7, 2009.
Abstract
Objective
Chronic cerebrospinal venous insufficiency (CCSVI) is characterized by combined stenoses of the principal pathways of extracranial venous drainage, including the internal jugular veins (IJVs) and the azygous (AZY) vein, with development of collateral circles and insufficient drainage shown by increased mean transit time in cerebral magnetic resonance (MR) perfusion studies. CCSVI is strongly associated with multiple sclerosis (MS). This study evaluated the safety of CCSVI endovascular treatment and its influence on the clinical outcome of the associated MS.
Methods
Sixty-five consecutive patients with CCSVI, subdivided by MS clinical course into 35 with relapsing remitting (RR), 20 with secondary progressive (SP), and 10 with primary progressive (PP) MS, underwent percutaneous transluminal angioplasty (PTA). Mean follow-up was 18 months. Vascular outcome measures were postoperative complications, venous pressure, and patency rate. Neurologic outcome measures were cognitive and motor function assessment, rate of MS relapse, rate of MR active positive-enhanced gadolinium MS lesions (Gad+), and quality of life (QOL) MS questionnaire.
Results
Outpatient endovascular treatment of CCSVI was feasible, with a minor and negligible complication rate. Postoperative venous pressure was significantly lower in the IJVs and AZY (P < .001). The risk of restenosis was higher in the IJVs compared with the AZY (patency rate: IJV, 53%; AZY, 96%; odds ratio, 16; 95% confidence interval, 3.5-72.5; P < .0001). CCSVI endovascular treatment significantly improved MS clinical outcome measures, especially in the RR group: the rate of relapse-free patients changed from 27% to 50% postoperatively (P < .001) and of MR Gad+ lesions from 50% to 12% (P < .0001). The Multiple Sclerosis Functional Composite at 1 year improved significantly in RR patients (P < .008) but not in PP or SP. Physical QOL improved significantly in RR (P < .01) and in PP patients (P < .03), with a positive trend in SP (P < .08). Mental QOL showed significant improvement in RR (P < .003) and in PP (P < .01), but not in SP.
Conclusions
PTA of venous strictures in patients with CCSVI is safe, and especially in patients with RR, the clinical course positively influenced clinical and QOL parameters of the associated MS compared with the preoperative assessment. Restenosis rates are elevated in the IJVs but very promising in the AZY, suggesting the need to improve endovascular techniques in the former. The results of this pilot study warrant a subsequent randomized control study.
在网上也看到波兰手术治疗MS的报告，这里简单谈谈。（需要说明，波兰医生手术不错，但主要是靠手术赚钱，基本不做研究，报告的科学性比较弱。）
回覆刪除他们检查发现95%的MS病人有静脉狭窄（支持意大利医生理论），他们手术了90个病人，主要用气囊治疗（63%），支架只是必要时候使用（21%），气囊+支架治疗（13%）。
治疗结果：大部分病人反映症状改善。总的来看，瘫痪程度轻的患者恢复比较明显。如果没有改善或者复发，通常意外静脉再次出现狭窄。