TY - JOUR
T1 - CCSVI and MS
T2 - A statement from the European Society of neurosonology and cerebral hemodynamics
AU - Baracchini, Claudio
AU - Valdueza, Jose M.
AU - Del Sette, Massimo
AU - Baltgaile, Galina
AU - Bartels, Eva
AU - Bornstein, Natan M.
AU - Klingelhoefer, Juergen
AU - Molina, Carlos
AU - Niederkorn, Kurt
AU - Siebler, Mario
AU - Sturzenegger, Matthias
AU - Ringelstein, Bernd E.
AU - Russell, David
AU - Csiba, Laszlo
PY - 2012/12
Y1 - 2012/12
N2 - To systematically review the ultrasonographic criteria proposed for the diagnosis of chronic cerebrospinal venous insufficiency (CCSVI). The authors analyzed the five ultrasonographic criteria, four extracranial and one intracranial, suggested for the diagnosis of CCSVI in multiple sclerosis (MS), together with the references from which these criteria were derived and the main studies that explored the physiology of cerebrospinal drainage. The proposed CCSVI criteria are questionable due to both methodological and technical errors: criteria 1 and 3 are based on a scientifically incorrect application of data obtained in a different setting; criteria 2 and 4 have never been validated before; criterion 2 is technically incorrect; criteria 3 and 5 are susceptible to so many external factors that it is difficult to state whether the data collected are pathological or a variation from the normal. It is also unclear how it was decided that two or more of these five ultrasound criteria may be used to diagnose CCSVI, since no validation of these criteria was performed by different and independent observers nor were they blindly compared with a validated gold-standard investigation. The European Society of Neurosonology and Cerebral Hemodynamics (ESNCH) has considerable concerns regarding the accuracy of the proposed criteria for CCSVI in MS. Therefore, any potentially harmful interventional treatment such as transluminal angioplasty and/or stenting should be strongly discouraged.
AB - To systematically review the ultrasonographic criteria proposed for the diagnosis of chronic cerebrospinal venous insufficiency (CCSVI). The authors analyzed the five ultrasonographic criteria, four extracranial and one intracranial, suggested for the diagnosis of CCSVI in multiple sclerosis (MS), together with the references from which these criteria were derived and the main studies that explored the physiology of cerebrospinal drainage. The proposed CCSVI criteria are questionable due to both methodological and technical errors: criteria 1 and 3 are based on a scientifically incorrect application of data obtained in a different setting; criteria 2 and 4 have never been validated before; criterion 2 is technically incorrect; criteria 3 and 5 are susceptible to so many external factors that it is difficult to state whether the data collected are pathological or a variation from the normal. It is also unclear how it was decided that two or more of these five ultrasound criteria may be used to diagnose CCSVI, since no validation of these criteria was performed by different and independent observers nor were they blindly compared with a validated gold-standard investigation. The European Society of Neurosonology and Cerebral Hemodynamics (ESNCH) has considerable concerns regarding the accuracy of the proposed criteria for CCSVI in MS. Therefore, any potentially harmful interventional treatment such as transluminal angioplasty and/or stenting should be strongly discouraged.
KW - CCSVI
KW - Multiple sclerosis
KW - Ultrasound
UR - http://www.scopus.com/inward/record.url?scp=84872114350&partnerID=8YFLogxK
UR - https://www-proquest-com.db.rsu.lv/docview/1197730997/fulltextPDF/F8804076EA714017PQ/1?accountid=32994
U2 - 10.1007/s00415-012-6541-3
DO - 10.1007/s00415-012-6541-3
M3 - Article
C2 - 22648477
AN - SCOPUS:84872114350
SN - 0340-5354
VL - 259
SP - 2585
EP - 2589
JO - Journal of Neurology
JF - Journal of Neurology
IS - 12
ER -