New Criteria Reduce Inter-Observer Variability in Chronic Cerebrospinal Venous Insufficiency: A Case Control Study

Massimiliano Farina*, Eugenio Novelli and Raffaello Pagani

New Criteria Reduce Inter-Observer Variability in Chronic Cerebrospinal
Venous Insufficiency: A Case Control Study

Two vascular sonographers who had undergone the same special training
performed all the investigations.

They were particularly experienced with venous diseases, and each one had
performed approximately 10,000 ultrasound investigations per
year over the past few years.

Each operator recorded all the scans for subsequent reconstruction and morphological analysis.
Thus, each of the two investigators, in a blind fashion regarding the observed subject,
also assessed all the exams performed by the other operator.

To compute the cross-sectional area of IJVs, we used an ellipsoid or continuous trace method,
referring to the greatest ellipse at the end-expiratory phase.

B-Mode is a two-dimensional ultrasound image display composed of bright
dots representing the ultrasound echoes.

The brightness of each dot is determined by the amplitude of the returned echo signal.
This allows for visualization and quantification of anatomical structures.

The M-mode represents movement of structures over time having a good temporal resolution,
so it is useful to study the movement of vessel walls and valves by detecting valve incompetence
and abnormal structures.

The M-mode will then show how the structures intersected by
that line move toward or away from the probe over time.

Valve defects related to leaflets movement were classified as mobile,
slightly mobile and not-mobile.

For transcranial and extracranial scans, we used the same ECD unit
equipped with a linear and a phased array transducer probe,
operating bandwidth 1-4 MHz and 3-11 MHz

The device, supplied with software for automatic calculation of the CCSVI score and
venous hemodynamic insufficiency severity score, was
upgraded in November 2011 according to the new revision of
the ECD criteria.

Neuro Open J. 2017; 4(1): 1-10. doi: 10.17140/NOJ-4-123