FIRST OPTION : STANDARD MRI SCANS FOR MULTIPLE SCLEROSIS.
Quotes below taken from the following.
« Magnetic resonance imaging (MRI) is the preferred imaging tool used to diagnose multiple sclerosis (MS), and to track the disease’s progression. It is the most non-invasive and sensitive way available of imaging the brain, spinal cord or other body areas.
MRI uses a strong magnetic field and radio waves — but not radiation — to measure the relative water content in tissues, whether normal or abnormal tissues. It creates detailed images of areas to reveal nerve damage (myelin that protects nerves is fatty and repels water, and demyelinated nerves retain more water). A contrast material may be injected in the patient’s veins to highlight lesions, improving their visibility…
There are different types of MRI scans
- T1-weighted scan. In this MRI technique, a contrast material (gadolinium) is injected into the patient’s veins to highlight newer, active areas of inflammation. Gadolinium is a large molecule that only enters the blood-brain barrier when there is active inflammation.
- T2-weighted scan. This is the most common MRI scan used to diagnose MS, and to detect areas of myelin damage (old and new) in the brain and spinal cord.
- FLAIR (fluid attenuated inversion recovery). This type of scan better identifies brain lesions that are associated with MS.
- Spinal cord imaging. This scan technique identifies damage in the spinal cord. It can help to establish a diagnosis of MS by demonstrating that damage has occurred in separate areas of the central nervous system (CNS) at different points in time. »
The National MS Society also has excellent, more detailed information on MRI.
Gadolinium contrast agent can be toxic to the kidneys. The following site reveals research that MS can be diagnosed without Gadolinium. https://www.everydayhealth.com/multiple-sclerosis/gadolinium-not-necessary-follow-up-m
O.K. Now we have the standard MRI scans used to diagnose MS and track its progression, all of which are used to identify lesions, both active and established. (According to the renowned MS researcher Dr George Ebers, some active lesions are in fact signs of healing, not damage.)
SECOND OPTION : SCHELLING-HAACKE MRI SCANS.
The renowned Interventional Radiologist Dr. Sclafani is now working with . https://ccsvi-clinic.com/enin Poland. If one consults their site, one will find a very comprehensive program of diagnosis and treatment for CCSVI which will be integrated into a scientific research study of the procedure. "Hemodynamic parameters and tissue biochemistry disorders in patients with multiple sclerosis co-existing with chronic cerebrospinal venous insufficiency. (CCSVI vs.SM)".
« Magnetic Resonance is performed according to a specially developed protocol of Dr. Schelling, which is an extension of Prof. Haacke's protocol. Based on this protocol, the lead doctor assess whether venous deformations have been observed in the patient and to what extent. »
Let’s be clear. The HAACKE IMAGING PROTOCOL focuses on veins and blood flow, NOT myelin lesions. Nonetheless, it begins with the Standard MRI protocol for MS diagnosis.
I have edited the following paper found in its entirety under
ONE : STANDARD MRI STUDY FOR MS. In Section 4 of his protocol, Professor Haacke refers to « Conventional data »
« These include: T1 weighted images (T1WI), T2 weighted images (T2WI), FLAIR (Fluid attenuation inversion recovery) images and post contrast T1WI images. These constitute part of the standard MRI protocol used to image MS patients clinically for many years. In this section, the first set of images represents the FLAIR data. FLAIR is very sensitive to MS lesions,which appear as hyperintense or hypointense signal in the white matter. We tend to choose 4 to 6 images at representative brain levels to show the MS lesions. The second series of images in this section is a comparison of the pre-contrast and post-contrast T1WI. If lesions appear enhanced post contrast, they are thought to represent acute lesions and these are then highlighted in the images with arrows. »
In short, standard MRI studies for MS focus on lesions, not veins. (And as Professor George Ebers has pointed out, lesions may indicate HEALING, not injury.)
TWO : MRI IMAGING WITH THE CCSVI OR HAACKE PROTOCOL
As can be seen from the following discussion which represents an edited version of Professor Haacke’s paper, the vascular system, particularly the veins, are the focus of the study. My apologies to Professor Haacke if my editing does not do justice to his full Protocol. (I suggest one read the entire Protocol.)
« Reports from the Haacke protocol are often made available to the patients. The report consists of four major components: 1. anatomical images of major neck and brain vessels as well as the azygous vein; 2. flow quantification of major neck vessels, major brain dural venous sinuses and the azygous vein; 3. conventional anatomical MRI sequences showing brain structures and, when present, examples of MS lesions; 4. susceptibility weighted imaging (SWI) showing the small venous structure of the brain, iron lesions in the brain white matter and measuring iron content in the major deep grey matter nucleus…
Section 2: Anatomical Information
In this section, two MRI sequences are used to evaluate the anatomical information of the major neck vessels and azygous vein… In the 3D CE MRAV sequence, a contrast agent is injected into the right or left medial cubital vein through a power injector. While the contrast agent passes through; the major neck arteries, brain arteries, brain capillary system, brain venous system and major neck veins, the MRI scanner takes snapshots (images acquired every 5 to 15 seconds) of the head and neck at different time points continuously for several minutes until most of the contrast agent washes out of the vascular system…This method is used to show the anatomy of the vessels and in particular whether the major veins are present or not. As long as the contrast agent can go through, regardless of the blood flow’s speed, the vessels will be seen in this set of images…
In summary, the first three sets of images from our report are from 3D CE MRV data. The first picture shows the dynamic changes of contrast agent going through the vascular system, the second picture shows the internal jugular veins and the third picture shows the vertebral venous system…In summary, the 3D CE MRV helps to localize where the abnormalities take place and the 2D TOF MRV shows the cross-section of the stenosed region. In this view we can then determine whether the cross section looks normal, is pancaked or uniformly stenosed… When there is inhomogeneous signal inside the vessel, it usually indicates unsteady or non-uniform flow (this could be turbulent or vortex flow).
The fifth set of images in this section represents the anatomical information of the azygos vein…
Section 3: Flow information
Flow quantification is performed using a special MRI sequence by encoding the flow inside the blood vessels. This sequence generates two sets of images: a magnitude image and a phaseimage.The magnitude image shows the vessel anatomy and the phase image can be used to quantitatively measure the velocity and direction of the blood flow…
Then the following parameters are calculated: integrated flow, volume flow rate, positive volume flow rate, negative volume flow rate, positive flow volume, average velocity, peak positive velocity, peak negative velocity, peak to average velocity ratio, average positive velocity and average negative velocity…
Currently, most sites measure the flow at four different locations: 1) the upper neck level, 2) lower neck level, 3) straight and sagittal sinus, and 4) azygos vein. …Five graphs are shown… These allow us to determine if there are abnormal flow patterns such as no flow, reverse or reflux flow, and circulatory flow patterns (often the case for widened bulbous lower levels in the internal jugular veins). ..…
Section 5: Susceptibility weighted imaging results discusses a complex study of iron deposits in both the bain’s white matter and grey matter
In this section, the table contains a list of the 7 structures and the four relevant iron measurement parameters. A check mark is placed in the box for that structure when there is abnormal iron content… Any patient beyond these intervals is assumed to have abnormal iron deposition in the structure plotted…
Why is all this important?
Having an MR scan prior to treatment is crucial for a number of reasons. First, it gives you a baseline of the brain tissue, MS lesions, vascular anatomy, flow characteristics, small veins, possibly perfusion if that is eventually added to the protocol, iron content, and the presence of any microbleeds or thrombus. Apart from the critical issue of acting as a treatment planning guide for the interventional radiologist or vascular surgeon, this information is the baseline from which you can judge what happens in the future. For example, do lesions go away, does blood flow improve, does iron content stay the same or reduce? Furthermore, if complications develop this baseline scan can help determine where the problem lies. All this is not possible if you do not have the initial scan run with the CCSVI protocol.
My Conclusion, the Haacke protocol is concerned with venous anatomy and, in particular, blood flow obstructions and speed, before and after treatment. Since MSers exhibit abnormal iron deposits- apparently related to blood flow - that too is of interest.
CAUTION : I assume the Polish CCSVI clinic studies the extrinsic factors which might impede venous blood flow – bones, muscles, arteries. I don’t know if the Haacke protocol does so.
I don’t know what Dr. Schelling adds to Professor Haacke’s protocol. When I « Googled » Dr. Schelling, my own blog for September 15, 2017 came up which reminded me of the Central Vein Sign. Dr Michael Flanagan had this to say about Dr Schelling. « It was Schelling who introduced the term venous back jets not Zamboni. He attributed the violent back jets to trauma » Flanagan quote Sept. 15, 2017. Joan Beal directed TIMS readers on her Central Vein Sign paper as follows :
PS--for those who wish to learn more about this history, Dr. Schelling has written the most comprehensive and thorough evaluation of the history of MS lesion studies.
Posted by Joan at 11:27 AM
From the beginning of MS « discovery » by Professor Charcot, the proximity of veins to MS lesions was observed. Somehow that well established fact hasn’t
filtered into MS research. I assume Professor Haacke’s interest in iron deposits refers to venous blood back jets.
On page 33 of his paper MULTIPLE SCLEROSIS : The Image and its Message. The Meaning of the Classic Lesion Form
Dr. F. Alfons Schelling, MD writes
« Since no really distinctive pathological traits have ever been posited for multiple sclerosis, the speculations as to the lesion’s cause(s) have always been mainly conformable to the dominant research interests of their time. » … « From toxin to virus, Modern Dogma : If not a viral agent, then an auto-immune process. »
So here we have the real problem with MS research and potential treatment – MODERN DOGMA which we all know favors the bio-chemical, that is to say DRUG, solution.
OPTION THREE : FONAR UPRIGHT MULTU POSITION CINE MRI
See FONAR MRI –Maker of the Upright Mult-Position MRI
Option Three also goes against MODERN DOGMA, even more so perhaps since preferred treatment may bypass the Medical Doctors altogether in favour of Chiropractors and other physical manipulation therapists. The renowned Chiropractor Dr.Michael Flanagan, author of THE DOWNSIDE OF UPRIGHT POSTURE – THE ANATOMICAL CAUSES OF ALZHEIMER’S, PARKINSON’S AND MULTIPLE SCLEROSIS, based on more than twenty years of research. introduced me to the FONAR and I’ll quote him directly here. (my editing)
C1, C2 and CSF Flow | Alzheimer's, Parkinson's and Multiple ...
« when it comes to blood and CSF flow, upright MRI is the wave of the future in brain research…
Cerebrospinal fluid (CSF) flow is called the third circulation of the brain and it is the least understood. CSF production and flow is critical to brain cushioning and protection. In terms of protection CSF is important to brain support to prevent the brain from sinking in the cranial vault. Conversely, excess CSF volume compresses the brain.
CSF comes from arterial blood that has been filtered through the blood brain barrier to the point where it is mostly water. CSF leaves thebrain through thevenous system. Therefore, backups in the venous drainage system affect cerebrospinal fluid (CSF) flow and drainage. Although it uses other routes as well, such as cranial and spinal nerves and the lymphatic system, most of the cerebrospinal fluid (CSF) produced by the brain eventually makes its way up to the superior sagittal sinus where it empties into the venous system…
About sixty percent of the CSF produced in the brain ends up in the spinal cord. Eventually most of the CSF in the spinal cord makes its way back up through the subarachnoid space of the cord and into the subarchnoid space of the brain. From there it travels up to the superior sagittal sinus and arachnoid granulations to exit the brain along with venous blood.
The movement of CSF is driven by cardiovascular waves arising from the heart and blood vessels…Thus, combined cardiorespiratory waves are important to the movement of CSF through the brain and cord…
the upper cervical spine is a critical link in the flow of CSF between the subarachnoid space of the brain and the cord…
Genetic design flaws, such as Chiari malformations, and acquired disorders from injuries or disease can impede the pulsatility and flow of CSF through the upper cervical spine…. It is therefore important to maintain the correct volume of CSF in order to provide sufficient brain support and protection, as well as to prevent hydrocephalus…
Misalignments, such as the one above (due to micro or macro trauma),genetic design flaws (Chiarimalformations), diseases (rheumatoid arthritis) and degenerative conditons (aging) of the upper cervical spinecan affect the vertebral arteries that supply the brain, as well as the vertebral veins that drain the brainduring upright posture. They can also cause deformation of the subarachnoid space and consequently, they can affect CSF flow going into and out of the brain and cord.
While CCSVI treatment can improve venous drainage, which may further relieve hydrocephalic conditions in certain cases, it cannot improve CSF flow through the subarachnoid space of the upper cervical spine.Furthermore, increasing venous drainage of the brain and consequently decreasing CSF volume without a proportionate rise in passive CSF production could compromise brain support causing it to sink in the vault resulting in a condition similar to a pressure conus or Chiari malformation...
The flow of CSF clearly plays a role in normal pressure hydrocephalus (NPH), which has been associated with Alzheimer’s and Parkinson’s disease. It also plays a role in Chiari malformations, which cause signs and symptoms similar to MS. »
MY CONCLUSION : The standard MS MRI is pre-occupied with the lesions. Treatment apparently focuses on suppressing the lesions, never mind what causes them. The Haacke CCSVI Protocol focuses on the veins, blood flow obstructions and velocity, and iron deposits thought to be related to poor blood flow. Venoplasty treatment seeks to « liberate » the blood flow. The FONAR upright cine MRI studies the cerebro-spinal fluid flow as well as the blood flows with the hope of freeing both by whatever therapy the diagnosis suggests, including Chiropractic.
I am informing here, not recommending. I myself would begin with Dr. Farough Owiesey’s ultrasound diagnostic imaging and subsequent treatment. For a discussion of this therapy, see my post of February 12, 2017 where I write « So as far as I can tell Dr. Owiesey is basically saying that a “vasospasm” causes the venous stenosis observed in CCSVI MS patients, and by relaxing the spasm one can prevent the stenosis, thus putting an end to the blood refluxes. »
There may be additional tools available to study fluid flows impacting the CNS (central nervous system), I don’t know. We should be able to count on our Neurologists to study the question correctly, direct us to appropriate diagnostic protocol and treatment. I have found it so difficult to be an MS patient under these conditions, being unable to trust my Neurologist to diagnose and treat the CNS fluid circulation problems in MS, having to find alternatives. And being treated with disdain for questioning standard DMD therapy, i.e. DOGMA.
TAGS : MRI, Magnetic Resonance Imaging, Prof. Haacke Protocol, CCSVI Clinic, Dr Sclafani, Dr Michael Flanagan, Dr. Anton Schelling, chiari malformations, venous blood flow, cerebral spinal fluid, central vein sign