Ultrasound and magnetic resonance of extrinsic stenosis and hypoplasia of internal jugular veins

S. Semenov, D. Bondarchuk, I. Malkov, M. Shatokhina
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Abstract

Highlights. Ultrasound and MR venography of internal jugular veins in case of unilateral cerebellar hypoplasia or extrinsic stenosis enables noninvasively and without contrast agents differentiation of these conditions due to local and region-specific indicators, including the area and velocity of blood flow, arterial-venous balance, visualization of low blood flow, compression factor, and the overall clinical picture of venous network of the neck remodeling and the development of collateral circulation.Aim. To compare the visual and hemodynamic characteristics of ultrasound and magnetic resonance venography of extrinsic stenosis and hypoplasia of internal jugular veins (IJV).Methods. Ultrasound and magnetic resonance (MR) venography were performed in 47 patients with extrinsic stenosis and 23 patients with hypoplasia of one of internal jugular veins, and in the control group (30 patients).Results. In case of obvious vein compression and deformation and local stenosis (65% on average), there is a decrease in the vein cross-sectional area by 2 times compared with the contralateral vein, the blood flow velocity in the stenotic vein in acute cases increases (on average, up to 45 cm/s), and in chronic cases it significantly (p = 0.00001) decreases (to 13 cm/s on average). The criteria for hypoplasia are the small caliber of the vein (on average 0.22 cm², within the range of 0.13–0.46 cm²) throughout its entire length - with the cross-sectional area not exceeding that of the common carotid artery, and the vein being 4 times smaller than IJV on contralateral side, as well as a significant (p = 0.0006) velocity increase on the contralateral side (on average 40.9±12.52 cm/s) with normal velocity in the hypoplastic vein. Ultrasound assessment of the arterial-venous balance (AVB) makes it possible to evaluate the contribution of each IJV to the outflow of venous blood from the brain separately. From the hypoplastic side it was only 11.01±6.72%, and from the stenotic side it was 18.22±17 42% on average, which is significantly (p = 0.000001) below the norm, but does not allow us to differentiate these conditions. The total AVB for IJVs on both sides was within normal values (65–85%), and the absence of a pronounced expansion of the vertebral veins during MR venography confirms their insignificant role in the compensatory mechanisms of ensuring adequate outflow of venous blood from the brain in cases of unilateral hypoplasia and extrinsic stenosis of IJV.Conclusion. Ultrasound and MR venography of internal jugular veins in cases of unilateral hypoplasia or extrinsic stenosis enable noninvasively and without contrast agents differentiation of these conditions due to local and region-specific indicators, including the area and velocity of blood flow, arterial-venous balance, visualization of low blood flow, compression factor, and the overall clinical picture of venous network of the neck remodeling and the development of collateral circulation.
颈内静脉外源性狭窄和发育不全的超声和磁共振分析
高光。在单侧小脑发育不全或外源性狭窄的情况下,颈内静脉的超声和MR静脉造影术可以根据局部和区域特异性指标(包括血流面积和速度、动静脉平衡、低血流量的可视化、压缩因子、静脉血流的变化)进行无创和无造影剂的区分。颈部静脉网络重构及侧支循环发展的临床整体情况。目的比较颈内静脉外源性狭窄和发育不全的超声和磁共振静脉造影的视觉和血流动力学特征。本文对47例颈内静脉外源性狭窄和23例颈内静脉发育不全患者及对照组(30例)进行了超声和磁共振(MR)静脉造影。静脉明显受压变形、局部狭窄(平均65%)时,静脉截面积比对侧静脉减少2倍,急性期狭窄静脉血流速度增加(平均可达45 cm/s),慢性期明显降低(平均13 cm/s) (p = 0.00001)。发育不全的标准是静脉全长小口径(平均0.22 cm²,在0.13-0.46 cm²范围内),横断面积不超过颈总动脉,且对侧静脉比颈总动脉小4倍,发育不全静脉对侧速度明显增加(平均40.9±12.52 cm/s),但速度正常(p = 0.0006)。动静脉平衡(AVB)的超声评估使得评估每个IJV对脑静脉血流出的贡献成为可能。发育不良侧仅为11.01±6.72%,狭窄侧平均为18.22±17.42%,明显低于正常值(p = 0.000001),但无法区分这两种情况。两侧IJVs的总AVB在正常值范围内(65-85%),MR静脉造影时椎静脉未见明显扩张,证实了它们在单侧发育不全和IJVs外源性狭窄的情况下,在保证充足的脑静脉流出的代偿机制中的作用微不足道。单侧发育不全或外源性狭窄病例的颈内静脉超声和MR静脉造影可以根据局部和区域特异性指标(包括血流面积和速度、动静脉平衡、低血流量可视化、压缩因子、颈部静脉网络重塑和侧支循环发展的整体临床图像)无创、无需造影剂鉴别这些情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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