Valecchi Debora, Bacci Duccio, Gulisano Massimo, Sgambati Eleonora, Sibilio Maurizio, Lipomas Mario, Macchi Claudio
Don Carlo Gnocchi Foundation, IRCCS, Florence, Italy.
Ital J Anat Embryol. 2010;115(3):185-9.
The presence of valves in the head and neck veins is known since classical anatomical dissections. Previous studies have investigated whether jugular veins show constant valves at their ostium and whether these valves are physiologically competent, but, unluckily, these studies have reported conflicting results. Further, recent observations have raised the question whether the incompetence of jugular vein valves might play a pivotal role in neurological disorders related to venous engorgement of the brain. In this study we examined 462 internal jugular veins by using an echocolorodoppler apparatus. In particular, we assessed the presence, morphology and competence of valves at their ostium. Unilateral jugular vein valves were present in 406 cases (88%), mainly on the right side. The most frequently observed morphology (75%, 305 cases) was the two-leaflet valve, and jugular vein valves were incompetent in the huge majority of cases (365 cases, 90%). Our findings confirm the anatomical variability predicted from classical anatomical studies but, unluckily, do not provide additional evidence on the possible role of jugular vein valves in physiology and pathology. Further studies are strongly needed to determine whether these valves actually play an important role in counteracting chest venous pressure and in preventing reflux towards the brain.
自经典解剖学解剖以来，人们就知道头颈部静脉中存在瓣膜。先前的研究调查了颈静脉在其开口处是否有恒定的瓣膜，以及这些瓣膜在生理上是否正常，但不幸的是，这些研究报告的结果相互矛盾。此外，最近的观察提出了一个问题，即颈静脉瓣膜功能不全是否可能在与脑静脉充血相关的神经系统疾病中起关键作用。在本研究中，我们使用超声彩色多普勒仪检查了462条颈内静脉。特别是，我们评估了瓣膜在其开口处的存在、形态和功能。406例（88%）存在单侧颈静脉瓣膜，主要在右侧。最常观察到的形态（75%，305例）是双叶瓣膜，并且在绝大多数病例（365例，90%）中颈静脉瓣膜功能不全。我们的研究结果证实了经典解剖学研究所预测的解剖学变异性，但不幸的是，没有提供关于颈静脉瓣膜在生理学和病理学中可能作用的额外证据。强烈需要进一步的研究来确定这些瓣膜是否实际上在抵消胸部静脉压力和防止血液反流至脑部方面发挥重要作用。
