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Ultrasound
Diagnosis
Vascular
Head and Neck
Jugular Vein Thrombosis
Jugular Vein Thrombosis
H. Y. Yuen, MBChB, FRCR; K. T. Wong, MBChB, FRCR; Carmen C. Cho, MBBS, FRCR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        TERMINOLOGY

        • Abbreviations

          • Jugular vein thrombosis (JVT)

        • Definitions

          • JVT: Chronic internal jugular vein (IJV) thrombosis (> 10 days after acute event) where clot persists within lumen after soft tissue inflammation subsides
          • Jugular vein thrombophlebitis: Acute to subacute thrombosis of IJV with associated adjacent tissue inflammation (myositis and fasciitis)

        IMAGING

        • General Features

          • Ultrasonographic Findings

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Angiographic Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      • Reporting Tips

                                        Selected References

                                        1. Bhatnagar P et al: Ultrasound scan in the emergency department revealed rare but potentially dangerous internal jugular vein thrombosis. Emerg Med J. 27(2):124, 2010
                                        2. Felstead AM et al: Thrombosis of the internal jugular vein: a rare but important operative finding. Br J Oral Maxillofac Surg. 48(3):195-6, 2010
                                        3. Iwata N et al: Lemierre syndrome: a Japanese patient returning from Thailand. J Infect Chemother. Epub ahead of print, 2010
                                        4. Binnebösel M et al: Internal jugular vein thrombosis presenting as a painful neck mass due to a spontaneous dislocated subclavian port catheter as long-term complication: a case report. Cases J. 2:7991, 2009
                                        5. Chen MH et al: Prolonged facial edema is an indicator of poor prognosis in patients with head and neck squamous cell carcinoma. Support Care Cancer. Epub ahead of print, 2009
                                        6. Chlumský J et al: Spontaneous jugular vein thrombosis. Acta Cardiol. 64(5):689-91, 2009
                                        7. Deganello A et al: Necrotizing fasciitis of the neck associated with Lemierre syndrome. Acta Otorhinolaryngol Ital. 29(3):160-3, 2009
                                        8. Hile LM et al: Lemierre syndrome complicating otitis externa: case report and literature review. J Emerg Med. Epub ahead of print, 2009
                                        9. Lemierre's syndrome, reemergence of a forgotten disease: a case report. Cases J. 2:6397, 2009
                                        10. Ball E et al: Internal jugular vein thrombosis in a warfarinised patient: a case report. J Med Case Reports. 1:184, 2007
                                        11. Ascher E et al: Morbidity and mortality associated with internal jugular vein thromboses. Vasc Endovascular Surg. 39(4):335-9, 2005
                                        12. Unsal EE et al: Spontaneous internal jugular vein thrombosis associated with distant malignancies. Eur Arch Otorhinolaryngol. 260(1):39-41, 2003
                                        13. Chirinos JA et al: The evolution of Lemierre syndrome: report of 2 cases and review of the literature. Medicine (Baltimore). 81(6):458-65, 2002
                                        14. Patel MC et al: Subclavian and internal jugular veins at Doppler US: abnormal cardiac pulsatility and respiratory phasicity as a predictor of complete central occlusion. Radiology. 211(2):579-83, 1999
                                        15. Provenzale JM et al: Systemic thrombosis in patients with antiphospholipid antibodies: lesion distribution and imaging findings. AJR Am J Roentgenol. 170(2):285-90, 1998
                                        16. Quraishi HA et al: Internal jugular vein thrombosis after functional and selective neck dissection. Arch Otolaryngol Head Neck Surg. 123(9):969-73, 1997
                                        17. Sakai O et al: Asymmetrical or heterogeneous enhancement of the internal jugular veins in contrast-enhanced CT of the head and neck. Neuroradiology. 39(4):292-5, 1997
                                        18. Poe LB et al: Acute internal jugular vein thrombosis associated with pseudoabscess of the retropharyngeal space. AJNR Am J Neuroradiol. 16(4 Suppl):892-6, 1995
                                        19. Colletti PM et al: Magnetic resonance angiography of the neck veins. Magn Reson Imaging. 11(2):279-83, 1993
                                        20. Tovi F et al: Septic internal jugular vein thrombosis. J Otolaryngol. 22(6):415-20, 1993
                                        21. Williams CE et al: Venous thrombosis in the neck. The role of real time ultrasound. Eur J Radiol. 9(1):32-6, 1989
                                        22. Gaitini D et al: High-resolution real-time ultrasonography. Diagnosis and follow-up of jugular and subclavian vein thrombosis. J Ultrasound Med. 7(11):621-7, 1988
                                        23. Weissleder R et al: Sonographic diagnosis of subclavian and internal jugular vein thrombosis. J Ultrasound Med. 6(10):577-87, 1987
                                        24. Erdman WA et al: Venous thrombosis: clinical and experimental MR imaging. Radiology. 161(1):233-8, 1986
                                        25. Wing V et al: Sonography of jugular vein thrombosis. AJR Am J Roentgenol. 140(2):333-6, 1983
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Jugular vein thrombosis (JVT)

                                              • Definitions

                                                • JVT: Chronic internal jugular vein (IJV) thrombosis (> 10 days after acute event) where clot persists within lumen after soft tissue inflammation subsides
                                                • Jugular vein thrombophlebitis: Acute to subacute thrombosis of IJV with associated adjacent tissue inflammation (myositis and fasciitis)

                                              IMAGING

                                              • General Features

                                                • Ultrasonographic Findings

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Angiographic Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Microscopic Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          • Image Interpretation Pearls

                                                                            • Reporting Tips

                                                                              Selected References

                                                                              1. Bhatnagar P et al: Ultrasound scan in the emergency department revealed rare but potentially dangerous internal jugular vein thrombosis. Emerg Med J. 27(2):124, 2010
                                                                              2. Felstead AM et al: Thrombosis of the internal jugular vein: a rare but important operative finding. Br J Oral Maxillofac Surg. 48(3):195-6, 2010
                                                                              3. Iwata N et al: Lemierre syndrome: a Japanese patient returning from Thailand. J Infect Chemother. Epub ahead of print, 2010
                                                                              4. Binnebösel M et al: Internal jugular vein thrombosis presenting as a painful neck mass due to a spontaneous dislocated subclavian port catheter as long-term complication: a case report. Cases J. 2:7991, 2009
                                                                              5. Chen MH et al: Prolonged facial edema is an indicator of poor prognosis in patients with head and neck squamous cell carcinoma. Support Care Cancer. Epub ahead of print, 2009
                                                                              6. Chlumský J et al: Spontaneous jugular vein thrombosis. Acta Cardiol. 64(5):689-91, 2009
                                                                              7. Deganello A et al: Necrotizing fasciitis of the neck associated with Lemierre syndrome. Acta Otorhinolaryngol Ital. 29(3):160-3, 2009
                                                                              8. Hile LM et al: Lemierre syndrome complicating otitis externa: case report and literature review. J Emerg Med. Epub ahead of print, 2009
                                                                              9. Lemierre's syndrome, reemergence of a forgotten disease: a case report. Cases J. 2:6397, 2009
                                                                              10. Ball E et al: Internal jugular vein thrombosis in a warfarinised patient: a case report. J Med Case Reports. 1:184, 2007
                                                                              11. Ascher E et al: Morbidity and mortality associated with internal jugular vein thromboses. Vasc Endovascular Surg. 39(4):335-9, 2005
                                                                              12. Unsal EE et al: Spontaneous internal jugular vein thrombosis associated with distant malignancies. Eur Arch Otorhinolaryngol. 260(1):39-41, 2003
                                                                              13. Chirinos JA et al: The evolution of Lemierre syndrome: report of 2 cases and review of the literature. Medicine (Baltimore). 81(6):458-65, 2002
                                                                              14. Patel MC et al: Subclavian and internal jugular veins at Doppler US: abnormal cardiac pulsatility and respiratory phasicity as a predictor of complete central occlusion. Radiology. 211(2):579-83, 1999
                                                                              15. Provenzale JM et al: Systemic thrombosis in patients with antiphospholipid antibodies: lesion distribution and imaging findings. AJR Am J Roentgenol. 170(2):285-90, 1998
                                                                              16. Quraishi HA et al: Internal jugular vein thrombosis after functional and selective neck dissection. Arch Otolaryngol Head Neck Surg. 123(9):969-73, 1997
                                                                              17. Sakai O et al: Asymmetrical or heterogeneous enhancement of the internal jugular veins in contrast-enhanced CT of the head and neck. Neuroradiology. 39(4):292-5, 1997
                                                                              18. Poe LB et al: Acute internal jugular vein thrombosis associated with pseudoabscess of the retropharyngeal space. AJNR Am J Neuroradiol. 16(4 Suppl):892-6, 1995
                                                                              19. Colletti PM et al: Magnetic resonance angiography of the neck veins. Magn Reson Imaging. 11(2):279-83, 1993
                                                                              20. Tovi F et al: Septic internal jugular vein thrombosis. J Otolaryngol. 22(6):415-20, 1993
                                                                              21. Williams CE et al: Venous thrombosis in the neck. The role of real time ultrasound. Eur J Radiol. 9(1):32-6, 1989
                                                                              22. Gaitini D et al: High-resolution real-time ultrasonography. Diagnosis and follow-up of jugular and subclavian vein thrombosis. J Ultrasound Med. 7(11):621-7, 1988
                                                                              23. Weissleder R et al: Sonographic diagnosis of subclavian and internal jugular vein thrombosis. J Ultrasound Med. 6(10):577-87, 1987
                                                                              24. Erdman WA et al: Venous thrombosis: clinical and experimental MR imaging. Radiology. 161(1):233-8, 1986
                                                                              25. Wing V et al: Sonography of jugular vein thrombosis. AJR Am J Roentgenol. 140(2):333-6, 1983