Detection of chronic cerebrospinal venous insufficiency through multigate Quality Doppler Profiles

Chronic cerebrospinal venous insufficiency (CCSVI) is a vascular syndrome in which deoxygenated blood flow from the veins surrounding the brain and the spine is slowed or blocked in its return to the heart. Among the criteria adopted for CCSVI diagnosis, the detection of possible intermittently reversed (reflux) flow in deep cerebral veins and sinuses, is of major importance. However, conventional ultrasound Doppler techniques are in many cases not capable of detecting the blood flow direction in these deep and narrow vessels. In this paper, we report on the integration of multigate spectral Doppler analysis, which allows to finely and independently detect blood velocities at different depths, in the MyLabVinco echo-color Doppler unit (Esaote SpA, Firenze, Italy). The unit has been targeted for this application through the introduction of the Directional Quality Doppler Profiles (QDP DIR) functionality, which highlights the flow direction in real-time. In vitro and in vivo examples, showing reflux or absence of reflux, are presented.