It’s not that Dr Samji is skeptical about vascular ES, but that he’ll assess people regardless of vascular symptoms. He likes to see the styloids on a regular CT, so isn’t worried about seeing a CT with contrast. If you want to see him or set up a phone consult, it’s worth making sure that you have a CT of the head & neck to send. There’s a discussion which explains what to send to him, if you search for CT protocol it’ll come up with it, but here’s a link to save you time:
Your MRV shows clear compression, but unfortunately MRI’s aren’t the best to diagnose ES because they show soft tissues, but a CT shows the styloids better. So not sure why the radiologist didn’t agree, maybe because of this being not the best scan to diagnose ES? Have you had a regular CT at all? It would be interesting to see how long the styloids look on that.