CCSVI Haacke MRI/MRV

11/08/2020

Most multiple sclerosis (MS) patients have had simple MRIs of their brain that take pictures to look for lesions. This is a very short and simple study that does not give much information, other than the number of lesions, location and whether the number has changed over time. The CCSVI Haacke MRI/MRV is very different than the normal MRI that an MS patient usually receives as a routine examination. It is also different than a standard MRV that simply looks at the veins of the neck. A standard MRV of a patient’s neck will show the anatomy of the veins. Often, this anatomic depiction of the veins is not very detailed. Also, it does not show any dynamic details depicting aspects of the flow within those veins.
Synergy Health concepts is the first and only practice in the world to incorporate the CCSVI Haacke MRI/MRV as an integral component of the CCSVI evaluation and treatment. This is possible because Synergy Health Concepts is the only facility in the world with physicians that are board certified to read the CCSVI Haacke MRI/MRV and also perform the CCSVI procedure. Synergy Health Concepts has performed more CCSVI Haacke MRI/MRVs than any other institution in the world; this gives us the experience needed to provide the most accurate interpretations that have meaningful impact on treatment.
The CCSVI Haacke MRI/MRV is unlike any other MRI. It includes a standard, but very high resolution, MRI of the brain to look for the multiple sclerosis or white matter plaques in the periventricular region of the patient’s brain. This portion of the MRI is advanced using contrast to look for any enhancement of the lesions, which is thought to denote active inflammation in those lesions. From there, the Haacke MRI becomes very different. The CCSVI Haacke MRI/MRV gives an exquisitely detailed view of the venous and arterial structures in the head, neck and chest. First of all, this is important because it allows us to look for significant anatomic abnormalities that could be associated with CCSVI. It also gives a very detailed 3-Dimensional mapping tool for us to plan the treatment, making it much safer and more effective for the patient.
One of the most notable hallmarks of the CCSVI Haacke MRI/MRVs is the ability to quantify the flow in the jugular veins and the azygos vein. This is important because the quantification of this flow tells us a lot about how the blood is moving in the veins, and by knowing how the blood is moving in the veins, it tells us whether there is a problem with the flow and whether there is a significant issue regarding how that blood is flowing through the vein. We look at different parameters for the flow – how fast the blood is flowing, whether the blood is flowing in the wrong or reverse direction and the quantity of blood that is flowing through the brain. All of these details regarding the flow are combined in great detail and give us a very important picture to the dynamic aspects of the venous system in the head, neck and chest. The CCSVI Haacke MRI/MRV also gives us a definitive yardstick by which to measure the patients blood flow at anytime after the procedure. This gives the treating physician and the patient a very powerful and reassuring tool when assessing the state of the patient’s veins for years to come.

The Haacke MRI is also very useful from the cerebral spinal fluid (CSF) perspective. It is the clear liquid that bathes and cleans our brain and acts as a shock absorber. It filters down from the brain, through the neck and into the spinal cord. There is a growing body of data to suggest that the flow of CSF, in addition to the flow of the venous blood out of the brain, is very significant. The Haacke MRI allows us to measure that flow of CSF to determine if there is a problem. Combining the knowledge of the CSF flow with the knowledge of the venous flow gives us a complete picture of the fluid forces that affect the health of the brain.
The Haacke MRI is also very useful because it quantifies iron in the brain, using very complex algorithms, used in what is called susceptibility-weighted imaging. The Haacke MRI is able to measure the amount of iron in lesions in the brain as well as iron in the deep white matter structures in the brain. The iron is thought to be a surrogate marker for brain injury, the MS plaques and perhaps the progression the disease. By knowing the amount of iron and being able to quantify it in the brain, it may allow us to gauge the effectiveness of the CCSVI treatment in the future. It may also be a useful measure of the effectiveness of other treatments.
At Synergy Health Concepts, we feel that the Haacke MRI may be the most useful and meaningful diagnostic test that all patients with neurodegenerative disease should receive prior to the intervention. There really is no other diagnostic imaging exam that provides the wealth of useful data benefiting the patient at the time of procedure, and also benefits them in their future clinical course. It also benefits research endeavors in a fashion that really cannot be matched by any other diagnostic evaluation.