Imaging Diagnosis—congenital Venous Aneurysm of the Left External Jugular Vein

Abstract

Primary congenital jugular vein aneurysms are rare with only one prior report in a canine patient. Herein, we describe an 18-week-old Flat Coated Retriever dog in which ultrasound was used to diagnose a primary congenital external jugular vein aneurysm with concurrent dilatation of the internal jugular vein. The aneurysm was successfully removed and the dog remains disease free 24 months postoperatively. Histopathologic analysis was used to validate the ultrasound-based diagnosis.

Congenital venous aneurysm of the right external jugular vein in a great dane

“…In the first case report published (Salmeri and others 1991), the diagnosis was made by venous angiography and histopathology. In the second case report (Routh and others 2009), the diagnosis was made by ultrasound and histopathology, similar to us. The location of the aneurysm was, in both previous reports, at the confluence of the linguofacial and maxillary veins into the external jugular vein (submandibular region), whereas in the present case, the aneurysm was located at the base of the neck.…”

“…The aneurysm was located at the bifurcation of the external jugular vein (in the submandibular region) in both dogs, unlike in the present case where it was located at the base of the neck. Routh and others (2009) hypothesised that hypoplasia or aplasia of the muscular layer at the bifurcation of the external jugular vein may be the aetiology of the aneurysm in their case, similar to what happens in human beings in case of arterial aneurysms at the level of branching of arterial trunks (Carmichael 1962). …”

“…The dilated segments were surgically excised (Salmeri and others 1991). Another case involved a flat coat retriever presented with a mass over the rostral left jugular furrow first noticed at two weeks of age (Routh and others 2009). Ultrasound allowed the diagnosis of an aneurysm, which was located at the level of the confluence of the linguofacial and maxillary veins into the external jugular vein.…”

Neck

“…The vessel wall may also appear thickened, particularly when thrombosis results from phlebitis, and the lumen is less compressible when transducer pressure is applied. 9 Multiple thrombi, which were heterogeneous in echogenicity, were identified within the aneurysm. [6][7][8] Thrombi can also form secondary to venous aneurysmal dilations, which have been reported in the head and neck.…”

“…Figure 6-35 shows the subtle difference between adduction and abduction of the laryngeal cartilages. In the transverse plane, it has a well-demarcated ventral (near-field) margin with reverberation and gas shadowing artifact extending dorsally (see [6][7][8][9][10][11][12][6][7][8][9][10][11][12][13][14][15]C and D;[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]B). 120 Because the normal larynx is air filled, satisfactory imaging planes may be difficult to attain, and only near-field anatomy is seen.…”