STUDY OF THE CHRONIC CEREBRO-SPINAL VENOUS INSUFFICIENCY IN A POPULATION OF YOUNG PEOPLE WITH MULTIPLE SCLEROSIS BY HEMODYNAMIC MAP MORPHOLOGICAL S. MANDOLESI; F. L. CICIARELLO; F. FEDELE; L. AGATI, A. MARCECA; UNIVERSITY SAPIENZA, DEPARTMENT OF CARDIOVASCULAR DESEASE, ROME, ITALY BACKGROUND: Multiple Sclerosis (MS) is the most common autoimmune neurological disorder in young adults. There are several different clinical types: Relapsing Remitting-MS (RR); Secondary Progressive –MS (SP); Primary Progressive –MS (PP). Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) is a new vascular pattern recently identified by Zamboni, who associated CCSVI with MS. MATERIALS AND METHOD: we included in this study 668 patients affected by MS (all clinical types). We divided them in 194 young patients: CCSVI positive 75,3 % (n=146) and CCSVI negative 24,7 % (n=48); 474 adult patients: CCSVI positive 85,7 % (n=406) and CCSVI negative 14,3 % (n=68). We studied only CCSVI positive population : 146 young patients CCSVI positive (GROUP 1), mean duration disease 5 years (women 60,8%, n=247; men 39,2%, n=159; mean age 47 years; mean EDSS 5). We investigated the population by means of high resolution B-mode ultrasounds (MyLab Vinco ECD System, equipped with 2.5 and Mhz probes) and hemodynamic according to Zamboni’s criterion to diagnose the CCSVI: 1-Reflux in the Internal Jugular Veins (IJVs) and/or Vertebral Veins (VVs); 2-Reflux in the Internal cerebral veins (DCVs); 3 -High-resolution B-mode-evidence of proximal IJV stenosis (Morphological and Hemodynamic stenosis); 4-Flow not Doppler detectable in the IJVs and/or VVs (block intra-venous); 5-Reverted postural control of the main cerebral venous outflow pathway, investigating in both positions (0°and 90°). The ECD examinations were then reported on Hemodynamic Map Morphological (HMM), it’s a new digital computerized software, created in our school, where the operator inserts symbols that correspond to the five Zamboni criteria. CONCLUSION RESULTS Hemodynamic Map Morphological enables us to see the presence of CCSVI, it simplifies the job of reporting to the operator and it facilitates statistical analysis of the CCSVI criteria; we believe that future studies are needed to explain a definite the correct use by scientific community. We believe that the “Criteria 4” is not only a block intra-venous but it could mean a external compression of a normal vein (IJVs). This vein with compression, that is not visible in the orthostatic and/or supine posture because empty in realty, expands itself with changes the position of the neck or Valsalva maneuver. Therefore this external compression, that create block intra-venous (IJVs), could be related to postural behavior and the increased of EDSS. We found a statistically significant prevalence of CCSVI within young and adults (young: positive 75,3%, negative 24,7% ; adults: pos 85,7%, negative 14,3% ) with data similar of the international scientific studies. Our study showed a uniformly distribution, in both groups, of all the CCSVI Criteria, in particular the Criteria 3 (IJV stenosis). Therefore the results of our study showed a statistically significant difference in the presence of the Criteria4 (Flow not Doppler detectable in the IJVs and Vertebral Veins; young : 50% and adults: 65% with p<0,001). The same statistically significant difference for the EDSS was present between young and adult patients (young mean 3 and adults mean 5, p<0,001). 72° SIC CONGRESS, December HEMODYNAMIC STENOSIS IJV Hemodynamic stenosis MORPHOLOGICAL STENOSIS IJV Morphological Stenosis CCA Symbols AIM: we analyzed the presence of CCSVI in a young population with less than 30 years old affected by MS, following Zamboni’s five ultrasound criteria and using an Hemodynamic Map Morphological (HMM), versus a large sample of adult patients with MS and more than 30 years old. CRITERIION 1 Symbols HEMODYNAMIC MAP MORPHOLOGICAL CRITERION 2CRITERION 3 CRITERION 4 CRITERION 5