J Clin Ultrasound. 2002 Jul-Aug;30(6):392-8.
Color Doppler sonographic finding of retrograde jugular venous flow as a sign of innominate vein occlusion.
Conkbayir I, Men S, Yanik B, Hekimoğlu B.
Department of Radiology, Social Security Ankara Hospital, TR-06110 Dişkapi, Ankara, Turkey.
Occlusion or stenosis of the superior vena cava, the innominate vein, or both is an important clinical problem that requires prompt diagnosis. To confirm a suspected occlusion, imaging studies revealing the obstruction and the presence of collateral venous routes are needed. Color Doppler sonography (CDUS) is widely used to evaluate suspected venous thrombosis and collateral pathways. We present the CDUS findings in 2 cases of innominate vein occlusion. In case 1, CDUS of the neck and left upper arm, which harbored a permanent hemodialysis access, showed engorged veins in the upper arm, a patent dialysis access, and some collateral veins in the axilla. The subclavian and internal jugular veins were patent, but the flow in the left internal jugular vein was reversed. The left innominate vein was occluded. In case 2, CDUS of the upper arms showed that the veins, the dialysis access in the left upper arm, and the subclavian and jugular veins were patent, but the flow in the left internal jugular vein and in the right subclavian vein was reversed. Collateral veins were seen in the right axillary region. Both innominate veins were occluded. The resulting collateral pathways, ie, retrograde flow in the ipsilateral jugular vein crossing to the contralateral jugular vein through dural sinuses, were confirmed by venography in both cases.
Because of stenoses in both the left and right innominate vein, the flow went up the left jugular, across the dural sinuses, and down the right jugular. (case 2)
Because of a left innominate vein occlusion, the flow in the left jugular was reversed. (case 1)
Reflux/retrograde flow up the jugular exists in other patients with central venous occlusions, just as it does in us with our jugular occlusions.
Here's another case of a patient with reverse jugular flow.http://ang.sagepub.com/content/47/7/699.abstract