The Morphology and Hemodynamic Characteristics of Patients with Internal Jugular Vein Stenosis

Objective: This study was to investigate the characteristic morphology and hemodynamics in patients with internal jugular vein (IJV) stenosis by color duplex ultrasonography (CDU).Methods: From 2017 October to 2019 October, 111 patients with unilateral IJV regional stenosis at the J3 segment (IJV out of the jugular foramen to the anatomic level of the carotid artery bifurcation) and 126 healthy individuals (control group) were enrolled. Using CDU, the diameter, maximum velocity (Vmax), maximum pressure gradient (PGmax), and mean flow volume (FVm) of bilateral IJVs were measured. With MR venous angiography (MRV) and/or CT venous angiography (CTV) as reference, the optimal cut-off values of Vmax and PGmax were determined by ROC analysis.Results: Among the 111 patients, 39 (35.1%) were associated with intracranial hypertension (ICH). The diameter at the IJV stenosis was significantly smaller than that of the segment distal to the stenosis (2.04 ± 0.36mm vs. 4.49 ± 0.68mm, t = 19.367, P < 0.001). The Vmax and PGmax at the IJV stenosis segment were obviously higher than those at the segment distal to the stenosis (Vmax: 106.8 ± 29.0 cm/s vs. 32.4 ± 13.1 cm/s, t = 29.259; PGmax: 5.10 ± 2.69 mmHg vs. 0.50 ± 0.53 mmHg, all P < 0.001). With MRV/CTV as reference, the ROC curves of Vmax and PGmax at the stenosis site showed high diagnostic efficacy. The optimal cut-off value of Vmax was 75cm/s, with a sensitivity of 87.4% and a specificity of 95.2%. The optimal cut-off value of PGmax was 2.2 mmHg, with a sensitivity of 92.8% and a specificity of 96.0%.Conclusion: CDU may be a useful method to evaluate IJV regional stenosis.