From the Department of Neuroradiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
AJNR Am J Neuroradiol. 2018 Aug;39(8):1505-1508. doi: 10.3174/ajnr.A5699. Epub 2018 May 31.
Superior ophthalmic vein enlargement has typically been associated with increased intracranial or orbital pressure. This study evaluates the incidence of superior ophthalmic vein enlargement in intubated patients without pre-existing intracranial or intraorbital pathologies.
Two cohorts (patients with trauma and epilepsy patients undergoing stereotactic intracranial lead placement) who underwent CT while intubated and shortly following extubation and a cohort of 30 outpatients with a history of headache and normal head CT findings (healthy controls) were included. The superior ophthalmic vein diameter was measured on all scans.
Seventy patients intubated for trauma and 45 patients with intraoperative CT were included ( = 115). While intubated, 66% of the total sample had at least unilateral superior ophthalmic vein dilation of >2.5 mm and 48% had bilateral dilation. Fifty-seven percent of patients with trauma and 84% of intraoperative patients with dilated superior ophthalmic veins showed reversal of mean superior ophthalmic vein dilation to <2.5 mm on postextubation CT. The mean superior ophthalmic vein diameter decreased an average of 1.2 mm following extubation. Changes in superior ophthalmic vein diameter between intubated and extubated states were statistically significant ( < .001). Differences between the control group and the extubated subjects were not statistically significant ( = .21).
Bilateral dilation of the superior ophthalmic vein is common in intubated patients and usually reverses following extubation. In the appropriate clinical setting, this knowledge will prevent misinterpretation of prominent superior ophthalmic veins as automatically indicative of an underlying pathology.
上腔静脉扩张通常与颅内或眶内压增高有关。本研究评估了无颅内或眶内先前病变的插管患者中上腔静脉扩张的发生率。
纳入了三组患者：创伤组（2 例）、接受立体定向颅内导丝放置的癫痫患者组（45 例）和有头痛病史且头部 CT 正常的门诊患者组（30 例，健康对照组）。所有患者在插管期间和拔管后不久均行 CT 检查，测量上腔静脉直径。
共纳入 70 例创伤患者和 45 例术中 CT 患者（共 115 例）。插管期间，总样本中 66%的患者至少有单侧上腔静脉扩张>2.5mm，48%的患者有双侧扩张。57%的创伤患者和 84%的术中上腔静脉扩张患者在拔管后 CT 上显示上腔静脉扩张平均直径<2.5mm。拔管后，上腔静脉平均直径缩小了 1.2mm。上腔静脉直径在插管和拔管状态之间的变化具有统计学意义（<0.001）。与拔管患者相比，对照组之间的差异无统计学意义（=0.21）。
插管患者中上腔静脉双侧扩张很常见，通常在拔管后可恢复正常。在适当的临床环境下，这一认识将避免将突出的上腔静脉错误地解释为潜在病理的标志。
