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Diagnosis and Follow‐up Study of Carotid Cavernous Fistulas With Color Doppler Ultrasonography
Author(s) -
Duan Yunyou,
Liu Xi,
Zhou Xiaoyan,
Cao Tiesheng,
Ruan Litao,
Zhao Yali
Publication year - 2005
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2005.24.6.739
Subject(s) - medicine , internal carotid artery , cavernous sinus , hemodynamics , fistula , angiography , radiology , blood flow , nuclear medicine , carotid cavernous fistula , cardiology
Objective The purpose of this study was to observe image characteristics and hemodynamic changes of carotid‐cavernous sinus fistulas (CCFs) and to evaluate the efficacy of interventional treatment for CCFs by color Doppler ultrasonography (CDUS). Methods Thirty‐three patients with suspected CCFs were studied with CDUS. Forty‐six volunteers took part in this study as controls. Scanning was performed through temporal, orbital, and occipital windows to measure the blood flow parameters of the internal carotid artery (ICA) and related vessels. All results were confirmed by cerebral angiography. Nineteen patients were followed after interventional treatment. Results Thirty‐two patients (97%) were found to have CCFs by CDUS. Irregular mosaic flashes were observed in the cavernous sinus region, the cross‐section areas of which were significantly larger than those of the normal intracranial ICA (1.7–5.2 versus 0.2–0.5 cm 2 ; P < .01). A lower resistive index of the ICA in the affected side was revealed with spectral analysis of relevant vessels. The peak velocity of vessels distal to the fistula was significantly lower than that of the healthy side and control group ( P < .05). Superior ophthalmic veins had a reversed arterialized flow pattern with a mean velocity of 34.5 cm/s and an average resistive index ± SD of 0.31 ± 0.08. In follow‐up study, the mosaic flashes and turbulence flow disappeared in 14 patients and remained in 5 after the interventional operation. Conclusions Combined with the direct sign of an irregular mosaic flash in the cavernous sinus region, hemodynamic changes in relevant branch vessels, and a reversed arterialized flow pattern in superior ophthalmic veins, CDUS has great value in confirming diagnosis and follow‐up study of CCFs.