Estimation of the diameter and cross-sectional area of the internal jugular veins in adult patients.

INTRODUCTION: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSIONS: 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.