目的: 分析颈内静脉超声受检者的临床资料及影像学资料,探讨颈内静脉检查的常见病变类型及相关危险因素。方法: 以包头市中心医院2017年7月—2023年5月在神经内科进行颈内静脉超声检测的150例患者为研究对象,分析所有患者超声、影像学资料和颈内静脉病变的常见类型,采用多因素Logistic回归分析颈内静脉疾病危险因素。结果: 与正常组相比,颈内静脉单侧狭窄组(局限性狭窄、长段纤细)患者发病年龄较小(41.85±19.19岁),常合并颅内静脉发育不良(P<0.05);与正常组相比,颈内静脉血栓组患者发病年龄较大(61.31±12.49岁),恶性肿瘤病史(OR=9.315,95%CI: 2.043-42.469)、贫血(OR=7.320,95%CI:1.715-31.234)、颈内静脉置管(OR=5.198,95%CI: 1.015-26.622)、慢性肾病病史(OR=10.080,95%CI: 1.082-93.937)、D-二聚体升高(OR=4.605,95%CI: 1.128-18.798)为颈内静脉血栓的危险因素。结论: 颈内静脉超声检测可清晰的显示颈内静脉血管结构及血流动力学情况,颈内静脉血栓是颈内静脉病超声检测的常见病变类型,恶性肿瘤病史、贫血、颈内静脉置管、慢性肾病病史、D-二聚体升高是颈内静脉血栓发生的危险因素。
Objective: To investigate the common lesion types and related risk factors of internal jugular vein examination byanalyzing the clinical data and imaging data of internal jugular vein ultrasound subjects. Methods: A total of 150 patients who underwent ultrasound examination of internal jugular vein in the Department of Neurology of Baotou Central Hospital from July 2017 to May 2023 were selected as the research objects. The ultrasound, imaging data and common types of internal jugular vein disease. Results: Compared with the normal group,the patients in the unilateral jugular vein stenosis group (localized stenosis, long thin segment) had a younger age of onset (41.85±19.19 years), and were often complicated with intracranial vein dysplasia (P<0.05). Compared with the normal group,the patients in the internal jugular vein thrombosis group had an older onset age (61.31±12.49 years).Multivariate analysis showed had a history of malignant tumor (OR=9.315, 95%CI: 2.043-42.469),anemia (OR=7.320, 95%CI: 1.715-31.234),internal jugular vein catheter (OR=5.198, 95%CI: 1.015-26.622),history of chronic kidney disease (OR=10.080, 95%CI: 1.082-93.937),and elevated D-dimer (OR=4.605, 95%CI:1.128-18.798) were risk factors for the patients of internal jugular vein thrombosis. Conclusion: Internal jugular vein ultrasound clearly show the structures and hemodynamics of internal jugular vein disease detected by ultrasound. History of malignant tumor, anemia, internal jugular vein catheterization, history of chronic kidney disease,and elevation of D-dimer are the risk factors for the internal jugular vein thrombosis.
[1] Bai CB, Chen ZY, Ding YC, et al. Long-term safety and efficacy of stenting on correcting internal jugular vein and cerebral venous sinus stenosis[J]. Ann Clin Transl Neurol, 2023, 10(8): 1305-1313.
[2] 中国卒中学会脑静脉病变分会. 头颈静脉回流障碍诊治中国专家共识[J]. 中华医学杂志, 2023, 103(17): 1257-1279.
[3] 贾凌云, 华扬, 唐煜, 等. 正常人颈内静脉结构和血流动力学的超声评估[J]. 中华超声影像学杂志, 2018, 27(12): 1025-1029.
[4] 中国超声医学工程学会浅表器官及外周血管超声专业委员会, 国家卫健委脑卒中防治工程专家委员会血管超声专业委员会, 中国超声医学工程学会颅脑及颈部血管超声专业委员会. 腹部及外周静脉血管超声若干临床常见问题专家共识[J]. 中国超声医学杂志, 2020, 36(11): 961-968.
[5] Hamzaoglu V, Ozalp H, Beger O, et al. Quantitative analysis of the vascular and neural compartments of the jugular foramen in dry skulls[J]. Turk Neurosurg, 2020, 30(6): 832-840.
[6] Doğan E, Apaydın M. The evaluation of cerebral venous normal anatomy and variations by phase-contrast cranial magnetic resonance venography[J]. Folia Morphol, 2022, 81(2): 314-323.
[7] Manjila S, Bazil T, Thomas M, et al. A review of extraaxial developmental venous anomalies of the brain involving dural venous flow or sinuses: persistent embryonic sinuses, sinus pericranii, venous varices or aneurysmal malformations, and enlarged emissary veins[J]. Neurosurg Focus, 2018, 45(1): E9.
[8] Fulop GA, Ahire C, Csipo T, et al. Cerebral venous congestion promotes blood-brain barrier disruption and neuroinflammation, impairing cognitive function in mice[J]. Gero Science, 2019, 41(5): 575-589.
[9] Mulder FI, Horváth-Puhó E, Van Es N, et al. Venous thromboembolism in cancer patients: a population-based cohort study[J]. Blood, 2021, 137(14): 1959-1969.
[10] Sharp W, Olivero JJ. Venous thrombosis in nephrotic syndrome[J]. Methodist Debakey Cardiovasc J, 2018, 14(3): 237-238.
[11] Gao XY, Liu YM, He Q, et al. Cerebral venous sinus thrombosis in nephrotic syndrome[J]. Kidney Int, 2022, 101(6): 1303.
[12] Zedde M, Portaro G, Ferri L, et al. Neurovascular manifestations of iron-deficient anemia: narrative review and practical reflections through a teaching case[J]. J Clin Med, 2022, 11(20): 6088.
[13] Shang WJ, Zhong KY, Shu LM, et al. Poor internal jugular venous outflow is associated with poor cortical venous outflow and outcomes after successful endovascular reperfusion therapy[J]. Brain Sci, 2022, 13(1): 32.
[14] Nyul-Toth A, Fulop GA, Tarantini S, et al. Cerebral venous congestion exacerbates cerebral microhemorrhages in mice[J]. GeroScience, 2022, 44(2): 805-816.
[15] Han K, Hu HH, Chao AC, et al. Transient global amnesia linked to impairment of brain venous drainage: an ultrasound investigation[J]. Front Neurol, 2019, 10: 67.