Editorial for "Internal Jugular Vein Geometry Under Multiple Inclination Angles with 3D Low-Field MRI in Healthy Volunteers"

Background Cerebral venous pathways are subjected to geometrical and patency changes due to body position. The internal jugular veins (IJVs) are the main venous drainage pathway in supine position. Their patency and geometry should be evaluated under different body inclination angles over a three-dimensional (3D) volume in the healthy situation to better understand pathological cases. Purpose To investigate whether positional changes in the body can affect the geometrical properties and patency of the venous system. Study Type Prospective. Population 15 healthy volunteers, of which seven males and median age 22 years in a range of 19-59. Field Strength/Sequence A 0.25-T tiltable MRI system was used to scan volunteers in 90 degrees (sitting position), 69 degrees, 45 degrees, 21 degrees, and 0 degrees (supine position) in the transverse plane with the top at vertebra C2. A gradient echo sequence was used. Assessment Three observers assessed IJVs on patency and created automatic centerlines from which diameter and patency were analysed perpendicular to the vessel at every 4 mm starting at the level of C2. Statistical Tests A Student's t test was used to find statistical difference (p < 0.05) in average IJV diameters per inclination angle. Results The amount of fully collapsed IJVs increased from 33% to 93% (left IJV) and 14% to 80% (right IJV) when increasing the inclination angle from 0 degrees to 90 degrees. In both IJVs, the mean diameter (+/- SD) of the open vessels was significantly higher at 0 degrees than 90 degrees with 6.3 +/- 0.5 mm vs. 4.4 +/- 0.1 mm (left IJV) and 6.6 +/- 0.6 mm vs. 4.3 +/- 0.4 mm (right IJV). Data Conclusion Tiltable low-field MRI can be used to assess IJV geometry and its associated venous pathways in 3D under multiple inclination angles. Next to a higher amount of collapsed vessels, the average diameter of noncollapsed vessels decreases with increasing inclination angles for both left and right IJVs. Level of Evidence 2 Technical Efficacy Stage 1