Vein Volume Research Articles

Longitudinal Volume Quantification of Deep Medullary Veins in Patients with Cerebral Venous Sinus Thrombosis : Venous Volume Assessment in Cerebral Venous Sinus Thrombosis Using SWI.

Susceptibility-weighted imaging (SWI) visualizes small cerebral veins with high sensitivity and could, thus, enable quantification of hemodynamics of deep medullary veins. We aimed to evaluate volume changes of deep medullary veins in patients with acute cerebral venous sinus thrombosis (CVST) over time in comparison to healthy controls. All magnetic resonance imaging (MRI) experiments were executed at 3 T using a32-channel head coil. Based on SWI and semiautomatic postprocessing (statistical parametric mapping [SPM8] and ANTs), the volume of deep medullary veins was quantified in 14patients with acute CVST at baseline and the 6‑month follow-up, as well as in 13healthy controls undergoing repeated MRI examination with an interscan interval of at least 1month. Deep medullary venous volume change over time was significantly different between healthy controls and patient groups (p< 0.001). Patients with superior sagittal sinus thrombosis (SSST) showed asignificant decline from baseline to follow-up measurements (9.8± 4.9 ml versus 7.5± 4.2 ml; p= 0.02), whereas in patients with transverse sinus thrombosis (TST) and healthy controls no significant volume changes were observable. Venous volume quantification was feasible and reproducible both in healthy volunteers and in patients. The decrease of venous volume in patients over time represents improvement of venous drainage, reduction of congestion, and normalization of microcirculation due to treatment. Thus, quantification of venous microcirculation could be valuable for estimation of prognosis and guidance of CVST therapy in the future.

Jugular and Portal Vein Volume, Middle Cerebral Vein Velocity, and Intracranial Pressure in Dry Immersion.

The objective was to determine if short term exposure to dry immersion (DI) results in a cephalic fluid shift similar to what has been observed with spaceflight. Data were collected from 10 individuals at rest and during the first 2 h of dry immersion. Jugular vein (JV), portal vein (PV), and thyroid volume were measured using 3D echography. Middle cerebral vein velocity (MCVv) was determined using transcranial Doppler ultrasound. The cochlear response to audio stimulation was used to derive an estimate of intracranial pressure (dICP). After 2 h of DI, there was a significant increase (mean ± SD) in JV (2.21 ± 1.10 mL), PV (1.05 ± 0.48 mL), and thyroid (0.428 ± 0.313 mL) volume. MCVv was also significantly increased with DI (3.90 ± 5.03 cm · s-1). There was no change in dICP with DI in part due to large individual variability. The range of dICP changes appeared to be related to MCVv, with participants with the largest increase in MCVv also showing increased dICP. The results suggest that DI induces a significant cephalic fluid shift similar to what is observed with spaceflight. The increased thyroid volume suggests that cerebral tissue may also be subjected to similar fluid filtration, with implications for changes in intracranial pressure. However, despite all participants having an increase in JV and thyroid volume, only half showed an increase in dICP, suggesting that increased venous pooling alone is not sufficient to cause increased intracranial pressure.Arbeille P, Avan P, Treffel L, Zuj K, Normand H, Denise P. Jugular and portal vein volume, middle cerebral vein velocity, and intracranial pressure in dry immersion. Aerosp Med Hum Perform. 2017; 88(5):457-462.

Pulmonary vascular volume, impaired left ventricular filling and dyspnea: The MESA Lung Study.

BackgroundEvaluation of impaired left ventricular (LV) filling has focused on intrinsic causes of LV dysfunction; however, pulmonary vascular changes may contribute to reduced LV filling and dyspnea. We hypothesized that lower total pulmonary vascular volume (TPVV) on computed tomography (CT) would be associated with dyspnea and decrements in LV end-diastolic volume, particularly among ever-smokers.MethodsThe Multi-Ethnic Study of Atherosclerosis recruited adults without clinical cardiovascular disease in 2000–02. In 2010–12, TPVV was ascertained as the volume of arteries and veins in the lungs detectable on non-contrast chest CT (vessels ≥1 mm diameter). Cardiac measures were assessed by magnetic resonance imaging (MRI). Dyspnea was self-reported.ResultsOf 2303 participants, 53% had ever smoked cigarettes. Among ever-smokers, a lower TPVV was associated with a lower LV end-diastolic volume (6.9 mL per SD TPVV), stroke volume, and cardiac output and with dyspnea (all P-values <0.001). Findings were similar among those without lung disease and those with 0–10 pack-years but were mostly non-significant among never-smokers. TPVV was associated smaller left atrial volume but not with LV ejection fraction or MRI measures of impaired LV relaxation. In a second sample of ever-smokers, a lower pulmonary microvascular blood volume on contrast-enhanced MRI was also associated with a lower LV end-diastolic volume (P-value = 0.008).ConclusionReductions in pulmonary vascular volume were associated with lower LV filling and dyspnea among ever-smokers, including those without lung disease, suggesting that smoking-related pulmonary vascular changes may contribute to symptoms and impair cardiac filling and function without evidence of impaired LV relaxation.

A reworked ∼3.45 Ga continental microblock of the North China Craton: Constraints from zircon U-Pb-Lu-Hf isotopic systematics of the Archean Beitai-Waitoushan migmatite-syenogranite complex

The Archean Beitai-Waitoushan migmatite-syenogranite complex (BWMC) is located in the northeast of the Anshan-Benxi continent block (ABCB) where has ∼3.8Ga rocks outcropped in the northeastern North China Craton (NCC). The BWMC consists chiefly of weakly migmatized tonalitic-trondhjemitic gneisses, migmatites with various volumes of potassium-rich granitoid veins from either syenogranite magma or anatexis of tonalitic- trondhjemitic gneisses, monzo- and syenogranitic intrusive rocks. LA-ICP-MS and SHRIMP zircon U-Th-Pb isotopic analyses reveal that the migmatized tonalitic-trondhjemitic gneisses were formed at 3454–3484Ma, and were the partial sources of the syenogranitic rocks and entire protolith of the migmatites. The dominant monzo- and syenogranitic magmas were emplaced at 2500–2540Ma and generally contain inherited Paleoarchean zircon grains with apparent 207Pb/206Pb ages of >3300Ma. An amphibolite sample in the form of boudin in the migmatized tonalitic-trondhjemitic gneisses formed at 3414Ma. These Paleoarchean rock samples and the inherited Paleoarchean zircons from the Neoarchean migmatites, monzo- and syenogranite samples indicate that a ∼3.45Ga continent microblock existed prior to the ∼2.50Ga migmatization and syenogranitic magmatism.When integrated with previous zircon Lu-Hf isotopic data from the study area, our new LA-ICP-MS zircon Lu-Hf isotope analyses for dated zircon spots from six dated samples reveal that the magmatic precursors of the ∼3.45Ga samples and the ancient inherited zircons from the Neoarchean migmatites and intrusive granitoid rocks were primarily derived from ∼3.45Ga partial melting of juvenile crustal materials from the depleted mantle, and either the mantle or more ancient continent crustal materials with CHUR-like Lu-Hf isotopic systematics. However, some of the Neoarchean monzo- and syenogranitoid rocks and the granitoid veins in the migmatites exhibit hybrid Lu-Hf isotopic features derived from both ancient ∼3.45Ga continental and Neoarchean juvenile crustal materials, including partial mixing between the Neoarchean granitoid magma and plastic Paleoarchean gneiss relicts.

EVERREST prospective study: a 6-year prospective study to define the clinical and biological characteristics of pregnancies affected by severe early onset fetal growth restriction

BackgroundFetal growth restriction (FGR) is a serious obstetric condition for which there is currently no treatment. The EVERREST Prospective Study has been designed to characterise the natural history of pregnancies affected by severe early onset FGR and establish a well phenotyped bio-bank. The findings will provide up-to-date information for clinicians and patients and inform the design and conduct of the EVERREST Clinical Trial: a phase I/IIa trial to assess the safety and efficacy of maternal vascular endothelial growth factor (VEGF) gene therapy in severe early onset FGR. Data and samples from the EVERREST Prospective Study will be used to identify ultrasound and/or biochemical markers of prognosis in pregnancies with an estimated fetal weight (EFW) <3rd centile between 20+0 and 26+6 weeks of gestation.MethodsThis is a 6 year European multicentre prospective cohort study, recruiting women with a singleton pregnancy where the EFW is <3rd centile for gestational age and <600 g at 20+0 to 26+6 weeks of gestation. Detailed data are collected on: maternal history; antenatal, peripartum, and postnatal maternal complications; health economic impact; psychological impact; neonatal condition, progress and complications; and infant growth and neurodevelopment to 2 years of corrected age in surviving infants. Standardised longitudinal ultrasound measurements are performed, including: fetal biometry; uterine artery, umbilical artery, middle cerebral artery, and ductus venosus Doppler velocimetry; and uterine artery and umbilical vein volume blood flow. Samples of maternal blood and urine, amniotic fluid (if amniocentesis performed), placenta, umbilical cord blood, and placental bed (if caesarean delivery performed) are collected for bio-banking. An initial analysis of maternal blood samples at enrolment is planned to identify biochemical markers that are predictors for fetal or neonatal death.DiscussionThe findings of the EVERREST Prospective Study will support the development of a novel therapy for severe early onset FGR by describing in detail the natural history of the disease and by identifying women whose pregnancies have the poorest outcomes, in whom a therapy might be most advantageous. The findings will also enable better counselling of couples with affected pregnancies, and provide a valuable resource for future research into the causes of FGR.Trial registrationNCT02097667 registered 31st October 2013.

550: Relationship between umbilical vein volume flow, umbilical artery and MCA doppler in late preterm growth restricted fetuses

550: Relationship between umbilical vein volume flow, umbilical artery and MCA doppler in late preterm growth restricted fetuses

Magnetic Resonance Venous Volume Measurements in Peripheral Artery Disease (from ELIMIT)

The relation between the arterial and venous systems in patients with impaired lower extremity blood flow remains poorly described. The objective of this secondary analysis of the Effectiveness of Intensive Lipid Modification Medication in Preventing the Progression on Peripheral Artery Disease Trial was to determine the association between femoral vein (FV) volumes and measurements of peripheral artery disease. FV wall, lumen, and total volumes were quantified with fast spin-echo proton density-weighted magnetic resonance imaging scans in 79 patients with peripheral artery disease over 2 years. Reproducibility was excellent for FV total vessel (intraclass correlation coefficient 0.924, confidence interval 0.910 to 0.935) and lumen volumes (intraclass correlation coefficient 0.893, confidence interval 0.873 to 0.910). Baseline superficial femoral artery volumes were directly associatedwith FV wall (r= 0.46, p <0.0001), lumen (r= 0.42, p=0.0001),and totalvolumes (r=0.46, p <0.0001). The 2-year change in maximum walking time was inversely associated with the 24-month change in FV total volume (r=-0.45, p= 0.03). Inconclusion, FV volumes can be measured reliably with fast spin-echo proton density-weighted magnetic resonance imaging, and baseline superficial femoral artery plaque burden is positively associated with FV volumes, whereas the 2-year change in FV volumes and leg function show an inverse relation.

A Novel Stocking to Improve Venous Return Compared to the Class 1 Compression Stocking

Category: Basic Sciences/Biologics Introduction/Purpose: Venous thromboembolism (VTE) is a serious risk of major orthopaedic surgery, associated with significant morbidity and mortality. VTE events are annually costing the US healthcare system over $13.5 billion and causing approximately 200,000 deaths each year. In current clinical practice, the risk of VTE events are reduced with various pharmacological and mechanical thromboprophylactic measures. Class 1 compression stockings are frequently used as mechanical prophylaxis due to few associated complications. The purpose of this study was to determine if the addition of a novel device to the conventional compression stockings improved venous return. Methods: This prospective study measured ejected venous volume (EVV) of the superficial femoral vein in both legs of healthy volunteers (n=10). The novel device wraps around the heel and holds the meta-tarsophalangeal joint of the great toe flexed, encouraging active toe dorsiflexion and partial ankle dorsiflexion. EVV was obtained using duplex scanning, and measured 1) when participants were supine at rest 2) with the addition of the compression stocking and 3) with the novel device in addition to the compression stocking. Results: The use of compression stockings compared to the baseline did not demonstrate a difference in EVV (6.13±0.43 ml vs 6.02±0.32 ml, p=1.000). However, the addition of the novel device significantly increased EVV compared to the baseline (6.13±0.43 ml vs 12.16±1.20 ml, p &lt; 0.001) and more importantly compared to the compression stockings alone (6.02±0.32 ml vs 12.16±1.20 ml, p &lt; 0.001). The novel device therefore augmented the EVV, two times greater than the compression stocking used as monotherapy. Conclusion: We have demonstrated that the addition of the novel device significantly improves venous return, compared to the compression stocking used as a monotherapy. DVT outcome studies assessing efficacy of this novel device in the clinical setting are now required. Nevertheless, these preliminary results demonstrate excellent potential in the next generation of VTE prophylaxis.

Reliability of cerebral vein volume quantification based on susceptibility-weighted imaging.

Susceptibility-weighted imaging (SWI) visualizes even small cerebral veins and might, therefore, be valuable in monitoring neurological diseases affecting cerebral veins. Since it is generally difficult to evaluate individual results of quantitative MRI measurements, an automatic approach would be highly appreciated to assist the diagnostic process. The aim of this study was to evaluate the rescan and reanalysis reliability using an automatic venous volumetric approach based on SWI in healthy controls. SWI was performed in ten healthy controls undergoing MRI examinations using a 32-channel head coil at 3T five times on five different days. To test for rescan and reanalysis variability, the deep cerebral vein volume was quantified using ANTs and SPM8. Total volumes of cerebral deep veins measured during five MRI scans in ten individuals (n = 50 scans) showed intra-individual volume changes ranging from 0.07 to 1.03ml (mean variability = 10.2%). Automatic reanalyses revealed exactly the same results in all scans. Automatic SWI-based cerebral vein volumetry shows acceptable rescan-and excellent reanalyses-reliability in healthy volunteers. Therefore, this approach might be beneficial in intra-individual follow-up studies of neurological diseases affecting the cerebral venous system.

Prenatal stress and hemodynamics in pregnancy: a systematic review.

Maternal prenatal stress is associated with preterm birth, intrauterine growth restriction, and developmental delay. However, the impact of prenatal stress on hemodynamics during pregnancy remains unclear. This systematic review was conducted in order to assess the quality of the evidence available to date regarding the relationship between prenatal stress and maternal-fetal hemodynamics. The PubMed/Medline, EMBASE, PsycINFO, Maternity and Infant Care, Trip, Cochrane Library, and CINAHL databases were searched using the search terms pregnancy; stress; fetus; blood; Doppler; ultrasound. Studies were eligible for inclusion if prenatal stress was assessed with standardized measures, hemodynamics was measured with Doppler ultrasound, and methods were adequately described. A specifically designed data extraction form was used. The methodological quality of included studies was assessed using well-accepted quality appraisal guidelines. Of 2532 studies reviewed, 12 met the criteria for inclusion. Six reported that prenatal stress significantly affects maternal or fetal hemodynamics; six found no significant association between maternal stress and circulation. Significant relationships between prenatal stress and uterine artery resistance (RI) and pulsatility (PI) indices, umbilical artery RI, PI, and systolic/diastolic ratio, fetal middle cerebral artery PI, cerebroplacental ratio, and umbilical vein volume blood flow were found. To date, there is limited evidence that prenatal stress is associated with changes in circulation. More carefully designed studies with larger sample sizes, repeated assessments across gestation, tighter control for confounding factors, and measures of pregnancy-specific stress will clarify this relationship.

Mathematical modelling of cardiovascular response to the Valsalva manoeuvre.

The Valsalva manoeuvre (VM) used for clinical autonomic testing results in a complex cardiovascular response with a concomitant action of several regulatory mechanisms whose nonlinear interactions are difficult to analyse without the aid of a mathematical model. The article presents a new non-pulsatile compartmental model of the human cardiovascular system with a variable intrathoracic pressure enabling the simulation of the haemodynamic response to the VM. The model is based on physiological data and includes three baroreflex mechanisms acting on heart rate, systemic resistance and venous unstressed volume. New nonlinear functions have been proposed to model cardiac output dependence on preload and afterload. Following the individual fitting of some parameters with a clear physiological meaning, the model is able to fit clinical data from patients with both typical and abnormal haemodynamic response to the VM. The sensitivity analysis showed that the model is most sensitive to the parameters describing the vascular pressure-volume relationships (the maximal volume of systemic veins and the relative level of vascular compliance). The use of nonlinear pressure-volume relationships for systemic veins proved crucial for the accurate modelling of the VM. On the contrary, the introduction of aroreflex time delays did not change significantly the haemodynamic response to the manoeuvre. The model can be a useful tool for aiding the interpretation of patient's response to the VM and provides a framework for analysing the interactions between the cardiovascular system and autonomic regulatory mechanisms.

Umbilical vein vasomotion detected in vivo by serial three-dimensional pixelwise spatially angle-corrected volume flow measurements.

To explore changes in volume flow in the umbilical vein in healthy second-trimester fetuses. This was a prospective observational pilot study performed at Stavanger University Hospital, Norway, between May and October 2013. Serial three-dimensional ultrasound recordings from the umbilical vein were acquired every 30 s in a 5-min period in 43 fetuses at 17-20 weeks' gestation. The recordings were analyzed with pixelwise spatially angle-corrected volume flow measurements. We observed variation in the umbilical vein volume flow in all fetuses, ranging from a mean minimum of 1.01 mL/s to a mean maximum of 2.60 mL/s. The minimum of all measurements was 57% compared with the mean value and the maximum was 148% of the mean value. The individual flow volume measurements ranged between 0.11 and 4.14 mL/s (mean, 1.76 mL/s). Within this range, an undulating course of all perfusion parameters was observed, with a full period of 4-5 min duration. Healthy second-trimester fetuses show cyclical variation in blood flow in the umbilical vein. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

Viral hepatitis associated hepatocellular carcinoma outcomes with Y-90 radioembolization.

414 Background: Viral associated malignancies have been shown to have improved outcomes. We sought to evaluate outcomes of patients with and without viral hepatitis (HBV and HCV) treated with lobar yttrium-90 radioembolization (RE) for multifocal, unresectable hepatocellular carcinoma (HCC). Methods: After IRB approval, an institutional database of patients with HCC who received RE between 2009-2015 was queried and 99 patients were identified that received a total of 122 lobar RE. Charts were reviewed to capture previous treatments, α-fetoprotein values (AFP), Child-Pugh class (CP), albumin-bilirubin score (ALBI), portal vein thrombosis (PVT), volumes treated and doses delivered. Comparison was made with Chi-Square and Mann-U Whitney when appropriate. Intrahepatic control (IHC), extrahepatic control (EHC), progression free survival (PFS), and overall survival (OS) were calculated according to the Kaplan-Meier method via log-rank. Hazard ratios were calculated using Cox regression. Results: Median follow up for viral hepatitis and non-viral hepatitis patients was 10.9 months (range 0.8-46.7 months) and 11.8 months (range 1.1-62.8 months), respectively. Patients with viral hepatitis associated HCC (n = 44) were younger and had smaller liver volumes; however there was no difference with respect to gender, pre-treatment AFP, CP, ALBI, PVT, extrahepatic disease, previous treatments, and dose given. Median dose for viral hepatitis and non-viral hepatitis patients was 129.5 Gy (range 90-215.8 Gy) and 131 Gy (range 100.9-265 Gy), respectively. 1 year IHC was 67% for viral associated HCC versus 34% for non-viral HCC (p = 0.067). 1 year EHC was 63% for viral associated HCC versus 86% for non-viral HCC (p = 0.027). 1 year PFS was 45% for viral associated HCC versus 31% for non-viral HCC (p = 0.56). 1 year OS was 46% for viral associated HCC versus 55% for non-viral patients (p = 0.55). On MVA, patients that received salvage treatments, CP A, no PVT, and without extrahepatic disease had improved OS. Conclusions: Patients with viral hepatitis associated HCC had improved IHC and significantly worse EHC. Consideration should be made for systemic therapy following Y-90 embolization in patients with viral hepatitis associated HCC.

Evaluation of venous return in lower limb by passive ankle exercise performed by PHARAD.

This paper presents evaluation of venous return, i.e., blood flow volume of vein (BF), in the lower limb after passive exercise performed by our developed "parallel link type human ankle rehabilitation assistive device (PHARAD)". The PHARAD can perform complex passive exercises (plantar flexion/dorsiflexion, inversion/eversion, adduction/abduction, and combination of these motions) by reproducing input motions of a foot plate that is attached to a sole of foot. The passive exercise can be performed for not only rehabilitation but also prevention of deep vein thrombosis (DVT). In this study, we measured the concentration of Total hemoglobin (Total-Hb) using multi-channel near infra-red spectroscopy (NIRS)-based tissue oximeters and calculated a gradient of Total-Hb during a venous occlusion. We defined the gradient as BF and evaluated BF after 3 min passive exercise performed by the PHARAD comparing to BF of resting. Seven healthy young adult people were recruited for the experiment and we assessed passive exercise, active exercise, and walking. Experimental results show that BF after the passive exercises significantly increases compare to BF of resting and this indicates that passive exercises performed by the PHARAD increases BF and has a potential to prevent DVT.

Percutaneous transhepatic portal embolization using foam ethanolamine oleate and carbon dioxide (CO₂): a pilot study.

Percutaneous transhepatic portal embolization (PTPE) can induce atrophy of the embolized- and hypertrophy of the residual area. These effects are advantageous in patients scheduled for extended hepatectomy. To evaluate the clinical safety and effectiveness of foam sclerotherapy with foam ethanolamine oleate (EO) and carbon dioxide (CO2) for PTPE before hepatectomy. We performed sclerotherapy for PTPE in 15 patients with: hepatocellular carcinoma (HHC; n = 9), bile duct carcinoma (n = 5), or metastatic liver tumor from colon cancer (n = 1). The foam contained 5% EO iopamidol (EOI) and CO2 at a 1:2 ratio. We compared the percentage of the pre- and post-PTPE future liver remnant (FLR) volumes and calculated the percent FLR volume (%FLR) increase after PTPE. The amount of EOI used (range, 14-20 mL; median, 16.8 mL) was based on the volume of the target portal vein. Technical success was achieved in 14 of 15 patients (93%); the other patient presented with computed tomography evidence of recanalization 1 week after PTPE. The FLR volume before and after portal vein embolization was 599 ± 342 and 691 ± 318 cm(3), respectively (P < 0.01); the mean %FLR volume increase was 29.5%. There was no significant difference in the mean platelet count, total bilirubin, total aspartate aminotransferase, and total creatinine before and after PTPE. One patient suffered intra-abdominal bleeding that required transcatheter arterial embolization. No other patients developed major complications higher than grade 3. Sclerotherapy using foam EOI and CO2 is clinically safe and effective for PTPE before hepatectomy.

P13.10: Sonographic measurement of the diameter and blood volume of umbilical vessels during mid‐trimester to predict small‐for‐gestational age

The objective of this study was to evaluate the diameter, blood velocity and blood volume of umbilical artery and vein using ultrasonography during mid-trimester of pregnancy to predict small for gestation age (SGA) at delivery. This study was performed in 104 low-risk pregnancies. Diameter, blood velocity and blood volume of umbilical artery and vein were measured between 20 and 25 weeks of gestation using ultrasonography and we checked the fetal birhweight among full term deliveries. We evaluated the reference value of its parameter during mid-trimester and analyzed the useful parameter to predict SGA at delivery. The mean diameter and blood volume of umbilical artery were increased according to gestational age from 20 to 25 weeks (r = 0.5678, p < 0.0001 and r = 0.4920, p < 0.0001, respectively), but the mean blood velocity of umbilical artery was not changed. The mean diameter and blood volume of umbilical vein were also increased according to gestational age (r = 0.7465, p < 0.0001 and r = 0.5837, p < 0.0001, respectively), but the blood velocity of umbilical vein was decreased without significance. SGA at delivery were 10 pregnancies (9.6%). Among its parameter during mid-trimester pregnancies, umbilical vein diameter was most predictable parameter to predict SGA (AUC = 0.769, p < 0.0001), and umbilical artery diameter and blood volume, and umbilical vein blood volume were also predictable for SGA. Diameter and blood volume of umbilical vessels are increased according to gestational age in low-risk pregnancies, but blood velocity of its vessels are not changed. Mid-trimester umbilical vein diameter seems to useful parameter to predict future SGA at delivery, although more additional parameters are related to fetal growth.

P19.10: Umbilical vein volume flow at 11–14 weeks in monochorionic twin pairs with subsequent twin–twin transfusion or selective intrauterine growth restriction

<scp>P</scp>19.10: Umbilical vein volume flow at 11–14 weeks in monochorionic twin pairs with subsequent twin–twin transfusion or selective intrauterine growth restriction

Flow Volumes of Internal Jugular Veins are Significantly Reduced in Patients with Cerebral Venous Sinus Thrombosis

The aim of this study was to investigate the flow volumes of the internal jugular veins (IJVs) in patients with cerebral venous sinus thrombosis (CVST) using Doppler ultrasonography (DUS) and to compare the findings with the control group. Forty patients diagnosed with CVST between 2008 and 2010 were included in the study. The patients diagnosed with a thrombosis via MRV and MRI underwent a bilateral examination of the IJVs by DUS. The patients were divided into three groups: Group I (n=29) unilateral total thrombosis; Group II (n= 6) bilateral diffuse thrombosis; and Group III (n=5) unilateral partial thrombosis. The IJV flow volumes of each group were compared to that of the control group (n=20). In Group I, the average flow volume was 53 ml/min on the side of the thrombosis. In Group II, the mean volume of the right and left IJV was 265 ml/min, and in Group III, the mean volume on the side of the partial thrombosis was 160 ml/min. The flow volume on the thrombosed side in Group I and Group III and the mean of the total bilateral flow volume in Group II were significantly lower than that of the control group. IJV flow volumes in the CVST group were significantly lower compared to the control group. Reduced flow volumes of the IJV may be diagnostic for CVST or an additional parameter to be considered with the use of MRI.

Umbilical vein volume flow in monochorionic twin pairs at 11–14 weeks

We investigated the umbilical vein volume flow (UVVF) at 11-14 weeks in monochorionic-diamniotic (MCDA) twins, focusing on the occurrence of complications. We considered 87 MCDA pregnancies. We used "E-flow" to detect the umbilical vein and measured the mean velocities and diameters of veins, also calculating the UVVF. Pregnancies were divided into four groups: a (twin-to-twin transfusion, TTTS); b (selective intrauterine growth restriction, sIUGR); c (discordance of fluid, DF); and d (with "normal" outcome). The main outcome of the study was the assessment of the difference of UVVF between twin 1 and twin 2 (larger and smaller twin). In eight of eight pairs of group a and seven of seven pairs of group b, the UVVF of fetuses 1 were significantly different than fetuses 2 (P<0.05). The UVVFs of fetuses 2 of group a were significantly lower in respect to the UVVFs of fetuses 2 of group d (P<0.05). We provide evidence of an important difference in UVVF in pairs that successively developed TTTS or sIUGR. The smaller fetuses of group a (TTTS) showed a lower venous return than fetuses 2 of group d (normal). First-trimester UVVF is lower in fetuses with a smaller crown-rump length in twin pairs at risk of TTTS or IUGR.

Letter Re: Internal jugular and vertebral vein volume flow in patients with clinically isolated syndrome or mild multiple sclerosis and healthy controls: results from a prospective sonographer-blinded study

Letter Re: Internal jugular and vertebral vein volume flow in patients with clinically isolated syndrome or mild multiple sclerosis and healthy controls: results from a prospective sonographer-blinded study