The role of ultrasound in assessing internal jugular vein respiratory variability and flow status in cerebrovenous sinus stenosis patients

Abstract Background The internal jugular vein (IJV) is the primary pathway for cerebrovenous drainage. Whether cerebrovenous outflow affects the respiratory variability (ReV) of the IJV remains unclear. Methods 30 patients diagnosed with cerebrovenous sinus stenosis (CVSS) and 38 controls were enrolled in the study. Ultrasound was used to monitor IJV_ReV and hemodynamic parameters. The ReV-related cross-sectional areas (CSA), including the maximum (Amax) and the minimum (Amin) were measured. Respiratory variation index (ReVI) was calculated. We investigated the association between sinovenous diameter, ReV-related CSAs and flow parameters in the IJVs. Results A significant increase in ReVI was observed in the patient group, alongside decreases in Amax, Amin, time-average mean velocity during baseline respiration (BVmean) and flow volume (FV). ReVI was moderately negatively correlated with sinovenous diameter. FV was significantly correlated with sinovenous diameter. Backward multivariate analysis identified ReVI (%) as a strong independent predictor of CVSS. An ReVI cutoff > 0.8350 indicated the highest sensitivity and negative predictive value, while an FV cutoff < 152.2 ml/min yielded an area under the curve of 0.9123. Conclusions Our study demonstrates that ultrasonography, a non-invasive modality, may effectively evaluate cerebrovenous drainage in CVSS patients using ReV-related and hemodynamic parameters.