Research Article
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Evaluating the cross-sectional area of the internal jugular vein in Turkish adults using ultrasonography

Year 2024, Volume: 10 Issue: 1 - January 2024, 84 - 91, 04.01.2024
https://doi.org/10.18621/eurj.1379905

Abstract

Objective: To assess the cross-sectional area (CSA) of the right and left internal jugular veins (IJVs) in the adult Turkish population.

Methods: The CSA of the IJVs was quantified at three anatomical landmarks: below the angle of the mandible, at the level of the cricothyroid membrane, and in the supraclavicular region. Measurements were taken under three conditions: at rest, during a deep breath hold, and throughout the Valsalva maneuver.

Results: The study encompassed 321 volunteers with a mean age of 30.40±7.75 years. At the anatomical landmarks of the angle of the mandible, cricothyroid, and supraclavicular regions, the CSA of the IJV in men was consistently larger than in women during rest, deep breath hold, and the Valsalva maneuver. During both the deep breath hold and the Valsalva maneuver at these landmarks, the right CSA of the IJV in both genders was greater than the left CSA. In both males and females, the CSA of the IJV at the supraclavicular location was superior to that at both the angle of the mandible and the cricothyroid regions. The CSA at the cricothyroid regions surpassed that at the angle of the mandible.

Conclusions: The CSA of the IJV was found to be the largest in the right supraclavicular region during the Valsalva maneuver in both genders. By accurately measuring the CSA of the IJV at the angle of the mandible, cricothyroid, and supraclavicular anatomical landmarks during a deep breath hold and the Valsalva maneuver, potential interventional and surgical risks can be mitigated.

Ethical Statement

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Etlik City Hospital Clinical Research Ethics Committee (Ankara, Türkiye) (date: 13.09.2023, no:2023-537)

Thanks

This research article was made possible with the help of volunteers to whom we are grateful.

References

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  • 2. Cvetko E. Unilateral fenestration of the internal jugular vein: a case report. Surg Radiol Anat. 2015;37(7):875-877. doi: 10.1007/s00276-015-1431-x.
  • 3. Parenti N, Bastiani L, Tripolino C, Bacchilega I. Ultrasound imaging and central venous pressure in spontaneously breathing patients: a comparison of ultrasound-based measures of internal jugular vein and inferior vena cava. Anaesthesiol Intensive Ther. 2022;54(2):150-155. doi: 10.5114/ait.2022.114469.
  • 4. Chawang HJ, Kaeley N, Bhardwaj BB, et al. Ultrasound-guided estimation of internal jugular vein collapsibility index in patients with shock in emergency department. Turk J Emerg Med. 2022;22(4):206-212. doi: 10.4103/2452-2473.357352.
  • 5. Vaidya GN, Kolodziej A, Stoner B, et al. Bedside ultrasound of the internal jugular vein to assess fluid status and right ventricular function: The POCUS-JVD study. Am J Emerg Med. 2023;70:151-156. doi: 10.1016/j.ajem.2023.05.042.
  • 6. Rafailidis V, Huang DY, Yusuf GT, Sidhu PS. General principles and overview of vascular contrast-enhanced ultrasonography. Ultrasonography. 2020;39(1):22-42. doi: 10.14366/usg.19022.
  • 7. Jeon JC, Choi WI, Lee JH, Lee SH. Anatomical morphology analysis of internal jugular veins and factors affecting internal jugular vein size. Medicina (Kaunas). 2020;56(3):135. doi: 10.3390/medicina56030135.
  • 8. Seçici S. Landmark guided internal jugular vein catheterization in infants undergoing congenital heart surgery. Eur Res J 2021;7(4):375-379. doi: 10.18621/eurj.748292.
  • 9. Kosnik N, Kowalski T, Lorenz L, Valacer M, Sakthi-Velavan S. Anatomical review of internal jugular vein cannulation. Folia Morphol (Warsz). 2023. doi: 10.5603/FM.a2023.0008.
  • 10. Judickas Š, Gineitytė D, Kezytė G, Gaižauskas E, Šerpytis M, Šipylaitė J. Is the Trendelenburg position the only way to better visualize internal jugular veins? Acta Med Litu. 2018;25(3):125-131. doi: 10.6001/actamedica.v25i3.3859.
  • 11. Laganà MM, Pirastru A, Ferrari F, et al. Cardiac and respiratory influences on intracranial and neck venous flow, estimated using real-time phase-contrast MRI. Biosensors (Basel). 2022;12(8):612. doi: 10.3390/bios12080612.
  • 12. Iankovitch A, Ledley JS, Almabrouk T, Al-Jaberi N, Coey J. Anatomical variations of the internal jugular vein in the context of central line placement: a visual approach to data processing. Clin Anat. 2023;36(2):172-177. doi: 10.1002/ca.23939.
  • 13. Salari M, Sasani MR, Masjedi M, Pourali A, Aghazadeh S. The association of diameter and depth of internal jugular and subclavian veins with hand dominancy. Electron Physician. 2018;10(7):7115-7119. doi: 10.19082/7115.
  • 14. Yoon HK, Lee HK, Jeon YT, Hwang JW, Lim SM, Park HP. Clinical significance of the cross-sectional area of the internal jugular vein. J Cardiothorac Vasc Anesth. 2013;27(4):685-689. doi: 10.1053/j.jvca.2012.10.007.
  • 15. Botero M, White SE, Younginer JG, Lobato EB. Effects of trendelenburg position and positive intrathoracic pressure on internal jugular vein cross-sectional area in anesthetized children. J Clin Anesth. 2001;13(2):90-93. doi: 10.1016/s0952-8180(01)00220-3.
  • 16. Saiki K, Tsurumoto T, Okamoto K, Wakebe T. Relation between bilateral differences in internal jugular vein caliber and flow patterns of dural venous sinuses. Anat Sci Int. 2013;88(3):141-150. doi: 10.1007/s12565-013-0176-z.
  • 17. Magnano C, Belov P, Krawiecki J, Hagemeier J, Beggs C, Zivadinov R. Internal Jugular Vein Cross-Sectional Area Enlargement Is Associated with Aging in Healthy Individuals. PLoS One. 2016;11(2):e0149532. doi: 10.1371/journal.pone.0149532.
  • 18. Giordano CR, Murtagh KR, Mills J, Deitte LA, Rice MJ, Tighe PJ. Locating the optimal internal jugular target site for central venous line placement. J Clin Anesth. 2016;33:198-202. doi: 10.1016/j.jclinane.2016.03.070.
  • 19. Zamboni P, Menegatti E, Pomidori L, et al. Does thoracic pump influence the cerebral venous return? J Appl Physiol (1985). 2012;112(5):904-10. doi: 10.1152/japplphysiol.00712.2011.
  • 20. Belov P, Magnano C, Krawiecki J, et al. Age-related brain atrophy may be mitigated by internal jugular vein enlargement in male individuals without neurologic disease. Phlebology. 2017;32(2):125-134. doi: 10.1177/0268355516633610.
Year 2024, Volume: 10 Issue: 1 - January 2024, 84 - 91, 04.01.2024
https://doi.org/10.18621/eurj.1379905

Abstract

References

  • 1. Du Y, Wang J, Jin L, Li C, Ma H, Dong S. Ultrasonographic assessment of anatomic relationship between the internal jugular vein and the common carotid artery in infants and children after ETT or LMA insertion: a prospective observational study. Front Pediatr. 2020;8:605762. doi: 10.3389/fped.2020.605762.
  • 2. Cvetko E. Unilateral fenestration of the internal jugular vein: a case report. Surg Radiol Anat. 2015;37(7):875-877. doi: 10.1007/s00276-015-1431-x.
  • 3. Parenti N, Bastiani L, Tripolino C, Bacchilega I. Ultrasound imaging and central venous pressure in spontaneously breathing patients: a comparison of ultrasound-based measures of internal jugular vein and inferior vena cava. Anaesthesiol Intensive Ther. 2022;54(2):150-155. doi: 10.5114/ait.2022.114469.
  • 4. Chawang HJ, Kaeley N, Bhardwaj BB, et al. Ultrasound-guided estimation of internal jugular vein collapsibility index in patients with shock in emergency department. Turk J Emerg Med. 2022;22(4):206-212. doi: 10.4103/2452-2473.357352.
  • 5. Vaidya GN, Kolodziej A, Stoner B, et al. Bedside ultrasound of the internal jugular vein to assess fluid status and right ventricular function: The POCUS-JVD study. Am J Emerg Med. 2023;70:151-156. doi: 10.1016/j.ajem.2023.05.042.
  • 6. Rafailidis V, Huang DY, Yusuf GT, Sidhu PS. General principles and overview of vascular contrast-enhanced ultrasonography. Ultrasonography. 2020;39(1):22-42. doi: 10.14366/usg.19022.
  • 7. Jeon JC, Choi WI, Lee JH, Lee SH. Anatomical morphology analysis of internal jugular veins and factors affecting internal jugular vein size. Medicina (Kaunas). 2020;56(3):135. doi: 10.3390/medicina56030135.
  • 8. Seçici S. Landmark guided internal jugular vein catheterization in infants undergoing congenital heart surgery. Eur Res J 2021;7(4):375-379. doi: 10.18621/eurj.748292.
  • 9. Kosnik N, Kowalski T, Lorenz L, Valacer M, Sakthi-Velavan S. Anatomical review of internal jugular vein cannulation. Folia Morphol (Warsz). 2023. doi: 10.5603/FM.a2023.0008.
  • 10. Judickas Š, Gineitytė D, Kezytė G, Gaižauskas E, Šerpytis M, Šipylaitė J. Is the Trendelenburg position the only way to better visualize internal jugular veins? Acta Med Litu. 2018;25(3):125-131. doi: 10.6001/actamedica.v25i3.3859.
  • 11. Laganà MM, Pirastru A, Ferrari F, et al. Cardiac and respiratory influences on intracranial and neck venous flow, estimated using real-time phase-contrast MRI. Biosensors (Basel). 2022;12(8):612. doi: 10.3390/bios12080612.
  • 12. Iankovitch A, Ledley JS, Almabrouk T, Al-Jaberi N, Coey J. Anatomical variations of the internal jugular vein in the context of central line placement: a visual approach to data processing. Clin Anat. 2023;36(2):172-177. doi: 10.1002/ca.23939.
  • 13. Salari M, Sasani MR, Masjedi M, Pourali A, Aghazadeh S. The association of diameter and depth of internal jugular and subclavian veins with hand dominancy. Electron Physician. 2018;10(7):7115-7119. doi: 10.19082/7115.
  • 14. Yoon HK, Lee HK, Jeon YT, Hwang JW, Lim SM, Park HP. Clinical significance of the cross-sectional area of the internal jugular vein. J Cardiothorac Vasc Anesth. 2013;27(4):685-689. doi: 10.1053/j.jvca.2012.10.007.
  • 15. Botero M, White SE, Younginer JG, Lobato EB. Effects of trendelenburg position and positive intrathoracic pressure on internal jugular vein cross-sectional area in anesthetized children. J Clin Anesth. 2001;13(2):90-93. doi: 10.1016/s0952-8180(01)00220-3.
  • 16. Saiki K, Tsurumoto T, Okamoto K, Wakebe T. Relation between bilateral differences in internal jugular vein caliber and flow patterns of dural venous sinuses. Anat Sci Int. 2013;88(3):141-150. doi: 10.1007/s12565-013-0176-z.
  • 17. Magnano C, Belov P, Krawiecki J, Hagemeier J, Beggs C, Zivadinov R. Internal Jugular Vein Cross-Sectional Area Enlargement Is Associated with Aging in Healthy Individuals. PLoS One. 2016;11(2):e0149532. doi: 10.1371/journal.pone.0149532.
  • 18. Giordano CR, Murtagh KR, Mills J, Deitte LA, Rice MJ, Tighe PJ. Locating the optimal internal jugular target site for central venous line placement. J Clin Anesth. 2016;33:198-202. doi: 10.1016/j.jclinane.2016.03.070.
  • 19. Zamboni P, Menegatti E, Pomidori L, et al. Does thoracic pump influence the cerebral venous return? J Appl Physiol (1985). 2012;112(5):904-10. doi: 10.1152/japplphysiol.00712.2011.
  • 20. Belov P, Magnano C, Krawiecki J, et al. Age-related brain atrophy may be mitigated by internal jugular vein enlargement in male individuals without neurologic disease. Phlebology. 2017;32(2):125-134. doi: 10.1177/0268355516633610.
There are 20 citations in total.

Details

Primary Language English
Subjects Radiology and Organ Imaging
Journal Section Original Articles
Authors

Doğa Özdemir Kalkan 0000-0002-2732-502X

Nezih Kavak 0000-0003-2751-0046

Early Pub Date December 15, 2023
Publication Date January 4, 2024
Submission Date October 23, 2023
Acceptance Date December 3, 2023
Published in Issue Year 2024 Volume: 10 Issue: 1 - January 2024

Cite

AMA Özdemir Kalkan D, Kavak N. Evaluating the cross-sectional area of the internal jugular vein in Turkish adults using ultrasonography. Eur Res J. January 2024;10(1):84-91. doi:10.18621/eurj.1379905

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