Variability in the cross-sectional area and narrowing of the internal jugular vein in patients without multiple sclerosis

Karen Buch, Raymond Groller, Rohini Narahari Nadgir, Akifumi Fujita, Muhammad M. Qureshi, Osamu Sakai

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. Chronic cerebrospinal vascular insufficiency is a proposed condition of intraluminal stenosis of the internal jugular vein (IJV) that impedes venous flow from the brain. Calculations of IJV stenosis are vague and described in veins with at least a 50% reduction in IJV caliber at a specific level. The purpose of this study was to assess normal changes in anatomic caliber of the course of the IJV in a generalized population. MATERIALS AND METHODS. Images from 500 consecutive contrast-enhanced neck CT studies performed in January-July 2011 were reviewed. Cross-sectional areas of the IJV were calculated at the jugular foramen, C1-C7 levels, and jugular angles bilaterally. Patients were excluded if they had severely motion-limited studies; limited clinical data; a history of multiple sclerosis, neck mass, or neck dissection; or known IJV occlusion. Normalized IJV cross-sectional areas at each level were compared with an averaged normalized crosssectional area from all patients at each level. RESULTS. Greater than 50% narrowing compared with a normalized average was found in 133 of 363 patients (36.6%) and was seen at all IJV levels. In 36.1% of patients this narrowing occurred at the C1 level. Most of the areas of narrowing greater than 50% occurred above the C4 level. CONCLUSION. The IJV has marked variability in its course in the neck. Areas of narrowing greater than 50% occur most commonly in the upper cervical and skull base regions. Given the normal anatomic variations in IJV caliber, caution should be used when making the diagnosis of and treating IJV stenosis.

Original languageEnglish (US)
Pages (from-to)1082-1086
Number of pages5
JournalAmerican Journal of Roentgenology
Volume206
Issue number5
DOIs
StatePublished - May 1 2016
Externally publishedYes

Fingerprint

Jugular Veins
Multiple Sclerosis
Neck
Pathologic Constriction
Anatomic Variation
Neck Dissection
Skull Base
Blood Vessels
Veins

Keywords

  • Anatomy
  • CT
  • Internal jugular vein
  • Measurement

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Variability in the cross-sectional area and narrowing of the internal jugular vein in patients without multiple sclerosis. / Buch, Karen; Groller, Raymond; Nadgir, Rohini Narahari; Fujita, Akifumi; Qureshi, Muhammad M.; Sakai, Osamu.

In: American Journal of Roentgenology, Vol. 206, No. 5, 01.05.2016, p. 1082-1086.

Research output: Contribution to journalArticle

Buch, Karen ; Groller, Raymond ; Nadgir, Rohini Narahari ; Fujita, Akifumi ; Qureshi, Muhammad M. ; Sakai, Osamu. / Variability in the cross-sectional area and narrowing of the internal jugular vein in patients without multiple sclerosis. In: American Journal of Roentgenology. 2016 ; Vol. 206, No. 5. pp. 1082-1086.
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abstract = "OBJECTIVE. Chronic cerebrospinal vascular insufficiency is a proposed condition of intraluminal stenosis of the internal jugular vein (IJV) that impedes venous flow from the brain. Calculations of IJV stenosis are vague and described in veins with at least a 50{\%} reduction in IJV caliber at a specific level. The purpose of this study was to assess normal changes in anatomic caliber of the course of the IJV in a generalized population. MATERIALS AND METHODS. Images from 500 consecutive contrast-enhanced neck CT studies performed in January-July 2011 were reviewed. Cross-sectional areas of the IJV were calculated at the jugular foramen, C1-C7 levels, and jugular angles bilaterally. Patients were excluded if they had severely motion-limited studies; limited clinical data; a history of multiple sclerosis, neck mass, or neck dissection; or known IJV occlusion. Normalized IJV cross-sectional areas at each level were compared with an averaged normalized crosssectional area from all patients at each level. RESULTS. Greater than 50{\%} narrowing compared with a normalized average was found in 133 of 363 patients (36.6{\%}) and was seen at all IJV levels. In 36.1{\%} of patients this narrowing occurred at the C1 level. Most of the areas of narrowing greater than 50{\%} occurred above the C4 level. CONCLUSION. The IJV has marked variability in its course in the neck. Areas of narrowing greater than 50{\%} occur most commonly in the upper cervical and skull base regions. Given the normal anatomic variations in IJV caliber, caution should be used when making the diagnosis of and treating IJV stenosis.",
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