Service d'Anesthésie-Réanimation 1, Université de Rennes 1, Hôpital Pontchaillou, 2 rue Henri Le Guilloux, 35000 Rennes, France.
Crit Care. 2009;13(6):R197. doi: 10.1186/cc8200. Epub 2009 Dec 9.
Unawareness of an asymmetry between the right and left internal jugular vein (IJV) and methodological pitfalls in previous studies raise concerns about such asymmetry. Hence the aim of this prospective non-interventional study was to validate the hypothesis that right IJV diameter is greater than those of left IJV and to determine the cross-sectional area of the IJVs using computed tomography (CT)-scans and original automatic software.
All consecutive adult outpatients who underwent a thoracic contrast-enhanced (TCE) helical CT-scan during a 5-month period were included. To determine diameter and cross sectional area of the IJVs, we used Advanced Vessel Analysis software integrated in a CT-scan (Advanced Vessel Analysis on Advantage Workstation Windows 4.2; General Electrics) allowing automatic segmentation of vessels and calculation of their diameters and cross-sectional areas.
A total of 360 TCE CT-scans was performed; 170 were excluded from the analysis. On the remaining 190 CT scans, the diameter and cross-sectional area of the right IJV were significantly greater than those of the left IJV (17 +/- 5 mm [median: 17 mm, range: 13 to 20 mm] vs. 14 +/- 5 mm [median: 13 mm, range: 10 to 16 mm], P < 0.001; and 181 +/- 111 mm2 [median: 160 mm2, range: 108 to 235 mm2] vs. 120 +/- 81 mm2 [median: 102 mm2, range: 63 to 168 mm2], P < 0.001, respectively).
In a general population of adult outpatients, the diameter and cross-sectional area of the right IJV were significantly greater than those of the left IJV. This could be an additional argument to prefer right over left IJV cannulation.
人们对右颈内静脉（IJV）和左颈内静脉之间的不对称性以及先前研究中的方法学缺陷认识不足，这引发了对这种不对称性的担忧。因此，本前瞻性非干预性研究旨在验证以下假设，即右颈内静脉的直径大于左颈内静脉，并使用计算机断层扫描（CT）和原始自动软件确定颈内静脉的横截面积。
在 5 个月期间，所有连续接受胸部增强（TCE）螺旋 CT 扫描的成年门诊患者均被纳入研究。为了确定颈内静脉的直径和横截面积，我们使用了集成在 CT 扫描中的高级血管分析软件（Advance Vessel Analysis 软件，在 Advantage Workstation Windows 4.2 版；通用电气公司），该软件可以自动对血管进行分段，并计算其直径和横截面积。
共进行了 360 次 TCE CT 扫描；其中 170 次被排除在分析之外。在其余的 190 次 CT 扫描中，右颈内静脉的直径和横截面积明显大于左颈内静脉（17 ± 5mm[中位数：17mm，范围：13 至 20mm]与 14 ± 5mm[中位数：13mm，范围：10 至 16mm]，P<0.001；181 ± 111mm2[中位数：160mm2，范围：108 至 235mm2]与 120 ± 81mm2[中位数：102mm2，范围：63 至 168mm2]，P<0.001）。
在成年门诊患者的一般人群中，右颈内静脉的直径和横截面积明显大于左颈内静脉。这可能是偏向于选择右颈内静脉而非左颈内静脉置管的另一个论据。
