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J Neurol Neurosurg Psychiatry doi:10.1136/jnnp.2010.231613
  • Research paper

The perfect crime? CCSVI not leaving a trace in MS

Table 2

Fulfillment of the five ‘Zamboni criteria’ in 20 MS patients and 20 healthy controls

Criterion Definition according to ‘Zamboni protocol’* No of MS patients No of controls p Value
1 Reflux >0.88 s in the IJVs and/or VVs in sitting or supine position 0 0 /
2 Reflux >0.5 s in the deep cerebral veins 0 0 /
3 High resolution B-mode evidence of IJV stenoses defined as VCSA of ≤0.3 cm 13 16 0.48
4 Flow not Doppler-detectable in at least one IJV or VV§ in the supine and upright position 0 1§ 1.0
5 Atypical main cerebral venous outflow measured in IJV defined as ΔVCSAupright–supine>0 0 0 /
At least two criteria fulfilled 0 1 1.0
  • * Zamboni et al.5

  • Fisher exact test.

  • Criterion 3 was not defined consistently by Zamboni et al. We used the definition in Zamboni et al,5 where a venous cross-sectional area (VCSA) of ≤0.3 cm2 is given as a cut-off value. Doepp et al21 obtained different results in assessing criterion 3, but referred to a deviating definition of ‘stenosis’ given in Zamboni et al,25a J Neurol Sci 2009;282:21–7, where a local VCSA reduction of ≥50% is considered ‘stenotic.’

  • § Criterion 4 is not specified clearly by Zamboni et al. Here, we defined criterion 4 as ‘no flow detectable in at least one internal jugular vein (IJV) or vertebral vein (VV) in the supine and the upright position.’

  • This Zamboni criterion was modified. Given that negative values for ΔVCSA in the IJV represent not a pathological but a physiological state, this criterion was substituted by ‘atypical flow,’ /, indicates p value could not be calculated. indicating a positive value of ΔVCSA.

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