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Prevalence of Incidental Narrowing of the Superior Segment of the Internal Jugular Vein in Patients Without Multiple Sclerosis

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Abstract

Purpose

Internal jugular vein (IJV) narrowing superiorly is likely relatively frequent. IJV narrowing has been proposed as a potential pathophysiologic component for multiple sclerosis (MS). Our purpose was to investigate the prevalence of incidental superior IJV narrowing in patients imaged with neck computed tomography angiography (CTA) for reasons unrelated to IJV pathology or MS.

Methods

We retrospectively identified 164 consecutive adult patients who had undergone neck CTA in which at least one IJV superior segment was opacified (158 right, 155 left IJVs). At the narrowest point of the upper IJV, each IJV was assessed for dominance, graded (shape and narrowing), measured (diameter and area), and located (axially and craniocaudally). Associations were analyzed using Spearman rank correlations (p < 0.05 significant). Medical records were reviewed for MS.

Results

Among 164 patients, at least one IJV was: absent/pinpoint in 15 % (25/164), occluded/nearly occluded in 26 % (43/164). Shape, narrowing, and the three measurements all correlated with each other (all p < 0.01). Lateral location with respect to C1 transverse foramen correlated with subjectively and objectively smaller IJVs (p < 0.01). The most common craniocaudal location was at the C1 transverse process (79 % (125/158) of right and 81 % (126/155) of left IJVs). No patient had a diagnosis of MS.

Conclusions

The appearance of the superior IJV is variable, with an occlusive/near-occlusive appearance present in approximately one-quarter of patients without known MS undergoing CTA. Radiologists should be aware of and cautious to report or ascribe clinical significance to this frequent anatomic variant.

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References

  1. Zamboni P, Galeotti R, Menegatti E, Malagoni AM, Tacconi G, Dall’Ara S, et al. Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry. 2009;80(4):392–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Zivadinov R, Lopez-Soriano A, Weinstock-Guttman B, Schirda CV, Magnano CR, Dolic K, et al. Use of MR venography for characterization of the extracranial venous system in patients with multiple sclerosis and healthy control subjects. Radiology. 2011;258(2):562–70.

    Article  PubMed  Google Scholar 

  3. Zivadinov R, Galeotti R, Hojnacki D, Menegatti E, Dwyer MG, Schirda C, et al. Value of MR venography for detection of internal jugular vein anomalies in multiple sclerosis: a pilot longitudinal study. AJNR Am J Neuroradiol. 2011;32(5):938–46.

    Article  CAS  PubMed  Google Scholar 

  4. McTaggart RA, Fischbein NJ, Elkins CJ, Hsiao A, Cutalo MJ, Rosenberg J, et al. Extracranial venous drainage patterns in patients with multiple sclerosis and healthy controls. AJNR Am J Neuroradiol. 2012;33(8):1615–20. doi:10.3174/ajnr.A3097.

    Google Scholar 

  5. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.

    Article  CAS  PubMed  Google Scholar 

  6. Zamboni P, Galeotti R, Menegatti E, Malagoni AM, Gianesini S, Bartolomei I, et al. A prospective open-label study of endovascular treatment of chronic cerebrospinal venous insufficiency. J Vasc Surg. 2009;50(6):1348–58 (e1–3).

    Article  PubMed  Google Scholar 

  7. Nicolaides AN, Morovic S, Menegatti E, Viselner G, Zamboni P. Screening for chronic cerebrospinal venous insufficiency (CCSVI) using ultrasound: recommendations for a protocol. Funct Neurol. 2011;26(4):229–48.

    CAS  PubMed Central  PubMed  Google Scholar 

  8. Mandato K, Englander M, Keating L, Vachon J, Siskin GP. Catheter venography and endovascular treatment of chronic cerebrospinal venous insufficiency. Tech Vasc Interv Radiol. 2012;15(2):121–30.

    Article  PubMed  Google Scholar 

  9. Mandato KD, Hegener PF, Siskin GP, Haskal ZJ, Englander MJ, Garla S, et al. Safety of endovascular treatment of chronic cerebrospinal venous insufficiency: a report of 240 patients with multiple sclerosis. J Vasc Interv Radiol. 2012;23(1):55–9.

    Article  PubMed  Google Scholar 

  10. Jayaraman MV, Boxerman JL, Davis LM, Haas RA, Rogg JM. Incidence of extrinsic compression of the internal jugular vein in unselected patients undergoing CT angiography. AJNR Am J Neuroradiol. 2012;33(7):1247–50.

    Article  CAS  PubMed  Google Scholar 

  11. Wattjes MP, Oosten BW van, Graaf WL de, Seewann A, Bot JC, den Berg R van, et al. No association of abnormal cranial venous drainage with multiple sclerosis: a magnetic resonance venography and flow-quantification study. J Neurol Neurosurg Psychiatry. 2011;82(4):429–35.

    Article  PubMed  Google Scholar 

  12. Seoane E, Rhoton AL Jr. Compression of the internal jugular vein by the transverse process of the atlas as the cause of cerebellar hemorrhage after supratentorial craniotomy. Surg Neurol. 1999;51(5):500–5.

    Article  CAS  PubMed  Google Scholar 

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Conflict of Interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Division of Neuroradiology, Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, 55905, MN, USA

    F. E. Diehn MD, K. M. Schwartz MD, C. H. Hunt MD, L. J. Eckel MD, N. G. Campeau MD & D. F. Kallmes MD

  2. Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, 200 1st St SW, Rochester, 55905, MN, USA

    R. E. Carter PhD & J. B. Allred

Authors
  1. F. E. Diehn MD
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  2. K. M. Schwartz MD
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  3. C. H. Hunt MD
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  4. L. J. Eckel MD
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  5. N. G. Campeau MD
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  6. R. E. Carter PhD
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  7. J. B. Allred
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  8. D. F. Kallmes MD
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Diehn, F., Schwartz, K., Hunt, C. et al. Prevalence of Incidental Narrowing of the Superior Segment of the Internal Jugular Vein in Patients Without Multiple Sclerosis. Clin Neuroradiol 24, 121–127 (2014). https://doi.org/10.1007/s00062-013-0232-z

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  • DOI: https://doi.org/10.1007/s00062-013-0232-z

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