CT evaluation of anatomical variations of the internal jugular veins in Thai adults

Abstract

Background: The internal jugular vein (IJV) is used to obtain central venous access for various reasons. Awarenessof the expected location and anatomic variations of the IJV is very important to avoid inadvertent arterial puncture. Objective: We evaluated anatomical variations of the IJVs, including diameter, depth from skin surface, relativedistance from common carotid artery (CCA) and position in relation to CCA in Thai adults by using CT scan ofthe neck.Material and Methods: A total of 77 patients who underwent CT scan of the neck (nasopharynx, larynx) at theDepartment of Radiology, King Chulalongkorn Memorial Hospital (KCMH) from May 1, 2009 to April 30, 2012were retrospectively reviewed. The diameter of the IJVs, depth from skin surface and relative distance betweenthe IJVs and CCAs were taken bilaterally. Bilateral CCAs were taken as reference points for measuring the locationof the IJVs, recorded as lateral, anterior, medial or posterior position. These parameters were evaluated usingthe same axial slice at a level of cricoid cartilage, which was compatible with the recommended point for centralvenous catheter insertion via the IJV. Intra- and interobserver reliability between researcher and anotherradiologist was assessed by intraclass correlation coefficient (ICC). Results: The right IJVs were usually larger than the left IJVs (57/77 or 74.0%) with significant difference indiameter (14.9 ± 4.0 mm vs. 11.6 ± 3.8 mm, p Conclusion: There were anatomical variations of the IJVs, including diameter, depth from skin surface, relativedistance from the CCAs and position in relation to CCAs, which remained potential risk when jugular venousaccess was attempted. Awareness of these variations is very important. Keywords: Central venous access, CT, internal jugular vein (IJV), Thai, variation