JUM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Duan, Y.
Right arrow Articles by Zhao, Y.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Duan, Y.
Right arrow Articles by Zhao, Y.
© 2005 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 24:739-745 • 0278-4297

Diagnosis and Follow-up Study of Carotid Cavernous Fistulas With Color Doppler Ultrasonography

Analysis of 33 Cases

Yunyou Duan, MD, Xi Liu, MD, Xiaoyan Zhou, MD, Tiesheng Cao, MD, Litao Ruan, MD and Yali Zhao, MD

Department of Ultrasound Diagnostics, Tangdu Hospital, the Fourth Military Medical University, Xi’an, China.

Address correspondence to Yunyou Duan, MD, Department of Ultrasound Diagnostics, Tangdu Hospital, the Fourth Military Medical University, Xi’an 710038, China. E-mail: duanyy{at}fmmu.edu.cn

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 cm2; 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.

Key Words: carotid-cavernous sinus • color Doppler ultrasonography • fistula

Abbreviations: ACA, anterior cerebral artery • BA, basilar artery • CCA, common carotid artery • CCF, carotid-cavernous sinus fistula • CDUS, color Doppler ultrasonography • ICA, internal carotid artery • MCA, middle cerebral artery • OA, ophthalmic artery • PCA, posterior cerebral artery • SOV, superior ophthalmic vein • VA, vertebral artery • Vmax • maximal systolic velocity

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2005 by the American Institute of Ultrasound in Medicine.