Color-coded Doppler sonography of the veins of the neck and upper extremities

  • P. Hübsch
  • S. Trattnig


The cervical veins can be divided into superficial and deep veins with respect to their position relative to the deep cervical fascia. The superficial veins drain the blood mostly to the external jugular vein. The internal jugular vein (IJV), which is the largest vein in the neck, receives blood from the sigmoid sinus, skull, face and a large portion of the neck (Fig. 1). The IJV is easily assessed sonographically, descending lateral to the internal and common carotid arteries to its junction with the brachiocephalic vein. Only the most cranial portion of the vein, including the superior bulb, cannot be sonographically visualized; the inferior bulb is readily demonstrated in most cases. Because of the clinical importance of the IJV, this vessel deserves special attention during sonographic evaluation of the neck.


Internal Jugular Vein Blood Flow Velocity Subclavian Vein External Jugular Vein Brachiocephalic Vein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Adams JT, McEvoy RK, DeWeese JA (1965) Primary deep venous thrombosis of upper extremity. Arch Surg 91: 29–35CrossRefGoogle Scholar
  2. Brownlow Jr RL, McKinney WM (1985) Ultrasonic evaluation of jugular venous valve competence. J Ultrasound Med 4: 169–172PubMedGoogle Scholar
  3. Campbell CB, Chandler JG, Tegtmeyer CJ (1977) Axillary, subclavian and brachiocephalic obstruction. Surgery 82: 816–822PubMedGoogle Scholar
  4. Comerota AJ, Harwick RD, White JV (1986) Jugular venous reconstruction: A technique to minimize morbidity of bilateral radical neck dissection. J Vasc Surg 3: 322–329Google Scholar
  5. Dresser LP, McKinney WM (1987) Anatomic and pathophysiologic studies of the human internal jugular valve. Am J Surgery 154: 220–224CrossRefGoogle Scholar
  6. Fitzgerald SP, Leckie WJH (1985) Thrombosis complicating transvenous pacemaker lead presenting as contralateral IJV occlusion. Am Heart J 109: 593–595PubMedCrossRefGoogle Scholar
  7. Grassi JC, Polak JF (1990) Axillary and subclavian venous thrombosis: Follow-up evaluation with color Doppler flow US and venography. Radiology 175: 651–654Google Scholar
  8. Gritzmann N, Grasl MCh, Helmer M, Steiner E (1990) Invasion of the carotid artery and jugular vein by lymph node metastases: Detection with sonography. AJR 154: 411–414Google Scholar
  9. Gritzmann N, Czembirek H, Hajek P, Kamel F, Frühwald F (1987) Sonographische Halsanatomie and ihre Bedeutung beim Lymphknotenstaging von Kopf-Hals-Malignomen. Fortschr Röntgenstr 146: 1–7CrossRefGoogle Scholar
  10. Falk RL, Smith DF (1987) Thrombosis of upper extremity thoracic inlet veins: Diagnosis with duplex Doppler sonography. AJR 149: 677–682Google Scholar
  11. Gaitini D, Kaftori JK, Pery M, Engel A (1988) High resolution real-time ultrasonography: Diagnosis and follow-up of jugular and subclavian vein thrombosis. J Ultrasound Med 7: 621–627Google Scholar
  12. Gooding GAW, Hightower DR, Moore DH, Dillon WP, Lipton MJ (1986) Obstruction of the superior vena cava or subclavian veins: Sonographic diagnosis. Radiology 159: 663–665Google Scholar
  13. Huber P, Häuptli W, Schmitt HE (1987) Die Axillar-Subclaviathrombose and ihre Folgen. Internist 28: 336–342PubMedGoogle Scholar
  14. Hübsch PJS, Stiglbauer RL, Schwaighofer BW, Kainberger FM, Barton PP (1988) Internal jugular and subclavian vein thrombosis caused by central venous catheters. Evaluation using Doppler blood flow imaging. J Ultrasound Med 7: 629–636Google Scholar
  15. Hedtler W, Geissmann A, Berchtold C (1987) Sonographie bei Jugularvenenthrombose. Ultraschall 8: 237–238CrossRefGoogle Scholar
  16. Hightower DR, Gooding GAW (1985) Sonographic evaluation of the normal response of subclavian veins to respiratory maneuvers. Invest Radiol 20: 517–520PubMedCrossRefGoogle Scholar
  17. Jost U (1983) Massive Thrombose durch Shaldon-Katheter zur Langzeit-Hämodialyse and Plasmapherese über die Vena jugularis interna. Anaesthesist 32: 560–562PubMedGoogle Scholar
  18. Kerr TM, Lutter KS, Moeller DM, Hasselfeld KA, Roedersheimer LR, McKenna PJ, Winkler JL, Spirtoff K, Sampson MG, Cranley JJ (1990) Upper extremity venous thrombosis diagnosed by duplex scanning. Am J Surg 160: 202–206PubMedCrossRefGoogle Scholar
  19. Knudson GJ, Wiedmeyer DA, Erickson SJ, Foley WD, Lawson TL, Mewissen MW, Lipchik EO (1990) Color Doppler sonographic imaging in the assessment of upper-extremity deep venous thrombosis. AJR 154: 399–403PubMedGoogle Scholar
  20. König R, Mukhopadhyay CH, Gademann G, Lorenz D (1986) Sonographischer, computertomographischer und kernspintomographischer Nachweis einer Thrombose der V. jugularis interna. Fortschr Röntgenstr 144: 611–614CrossRefGoogle Scholar
  21. von Lanz T, Wachsmuth W (1955) Praktische Anatomie, Bd I, 2. Teil: Hals. Springer, Berlin Göttingen HeidelbergGoogle Scholar
  22. Leung A, Hampson SJ, Singh MP, Charr D (1983) Ultrasonic diagnosis of bilateral congenital jugular venous aneurysms. Br J Rad 56: 588–591CrossRefGoogle Scholar
  23. Schmidt RF, Thews G (Hrsg) (1980) Physiologie des Menschen, 20. Aufl. Springer, Berlin Heidelberg New YorkGoogle Scholar
  24. Terwey B, Krier C, Gerhardt P (1981) Die Darstellung der Jugularvenenthrombose mit Hilfe des hochauflösenden Ultraschallverfahrens. Fortschr Röntgenstr 134: 557–559CrossRefGoogle Scholar
  25. Tilney NL, Griffiths HJ, Edwards EA (1970) Natural history of major venous thrombosis of the upper extremity. Arch Surg 101: 792–796PubMedCrossRefGoogle Scholar
  26. Wing V, Scheible W (1983) Sonography of jugular vein thrombosis. AJR 140: 333–336PubMedGoogle Scholar
  27. Warwick R, Williams PL (eds) (1989) Gray’s anatomy, 37th edn. Churchill Livingstone, Edinburgh London Melbourne New YorkGoogle Scholar
  28. Yiengpruksawan A, Ganepola GA, Freeman HP (1987) Thrombosis of noncatheterized internal jugular vein: A unique complication of subclavian catheterization diagnosed by ultrasound. J Natl Med Assoc 79: 961–965Google Scholar
  29. Yokomori K, Kubo K, Kanamori Y, Takemura T, Yamamoto T (1990) Internal jugular phlebectasia in two siblings• manometric and histopathologic studies of the pathogenesis. J Pediatr Surg 25: 762–765PubMedCrossRefGoogle Scholar
  30. Zanella FE, Brusis T, Moedder U (1986) Der Einsatz bildgebender Verfahren in der Diagnostik der Jugularvenenthrombose. Laryngol Rhinol Otol 65: 322–326CrossRefGoogle Scholar
  31. Zohar Y, Ben-Tovim R, Talmi YP (1989) Phlebectasia of the jugular system. J Craniomaxillofac Surg 17: 96–98PubMedCrossRefGoogle Scholar

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© Springer-Verlag/Wien 1992

Authors and Affiliations

  • P. Hübsch
  • S. Trattnig

There are no affiliations available

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