Table 1

Advantages and disadvantages of noninvasive diagnostic methods for diagnosis of chronic cerebrospinal venous insufficiency
Noninvasive diagnostic methods Advantages Disadvantages
Doppler sonography[18,27,30-32,34,78-101] - noninvasive - no standardized guidelines
- without ionizing radiation - operator dependent
- less expensive - time consuming (60 to 120 minutes)
- high resolution - blinding procedures are challenging
- real time information - cannot perform global view of the veins (limited window)
- sensitive to detect flow changes, intra- and extra-luminal abnormalities - misidentification of the veins
- ability to measure velocity - influenced by hydration status
- possible control of respiratory phases
Magnetic resonance venography[10,30,31,34,42,43,102] - noninvasive - no real time information
- without ionizing radiation - cannot detect intra-luminal abnormalities
- well established method - low specificity of conventional MRV techniques
- operator independent - influenced by hydration status
- less time consuming than DS - azygos vein examination needs technical improvements due to important artifacts (breathing, heart movements)
- provide global view of intra- and extra-cranial venous system - underestimates the vascular caliber
- easy to blind - “snapshot” nature
- ability to measure flow and velocity with advanced technique (phase contrast MRV)
- global view of collateral veins
- can be performed without contrast (pregnancy, allergy)
Computed tomography venography[5,103,104] - noninvasive - ionizing radiation
- less expensive and time consuming than MRV - no real time information
- better spatial resolution than MRV - cannot detect intra-luminal abnormalities
- global view of veins - cannot be performed without contrast (allergy, toxicity)
- lack of experience for extra-cranial venous system - less contrast resolution than MRV
Plethysmography[105,106] - noninvasive - higher false-positive rate due to venous compression arising from incorrect patient positioning or the action of extrinsic masses
- provides valuable information regarding the impact of reflux and obstruction on overall venous function - low resolution
- can monitor the dynamics of venous disease over time and evaluation of treatment outcomes

Legend: DS, Doppler sonography; MRV, Magnetic Resonance Venography.

Dolic et al.

Dolic et al. BMC Medicine 2013 11:155   doi:10.1186/1741-7015-11-155

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