This is strange. I've the game with latest patch + HD official pack + skse loader. If I change values in Nvidia Inspector, this seems that not affect the graphic in the game.
The only changements are when I disable all filters in NV Inspector. But, for example, http://img.techpowerup.org/120209/TESV%202012-02-09%2013-33-38-11.jpg you can view an image with Nv Inspector set with these values:
AA-Mode: Override any application setting
AA-Setting: 32x [32x CSAA (8 color + 24 cv samples)]
Ambient Occlusion set to High quality.
http://img.techpowerup.org/120209/TESV%202012-02-09%2013-41-28-55.jpg there is the same image but with NV inspector set with AA 4x Multisample and Ambient Occlusion Disabled.
Why look the same? I've tried also in other locations but nothing change.
I've also added skse loader.exe to application profile.

You must have AA and AF set in the ingame launcher for the Nvidia Inspector values to work. I don't know why but when I set AA and AF in launcher to zero then nothing I do in inspector works.

Set AA to 8 and AF to 16 in Launcher and thenkeep those settings you listed. I would removed Ambient Occlusion it would ruin your fps. I have a i5 @ 4.3ghz and a GTX 580 and Ambient Occlusion murders my FPS.

You may find that Skyrim wont load with any CSAA setting (skyrim doesnt support it) and will have artifacts with non-transparency supersampling.

I use 32xS (not 32xCSAA) with 2x transparency supersampling amd it looks amazing with Realistic Lighting with Customization, especially if you play with a controller and meter or so away from the monitor.

That help?

No man. Me too hate Ambient Occlusion, but it's only for try NV Inspector settings.

Seems that I've resolved simply loading a normal save and not a quick save...