Color Doppler Imaging in the Diagnosis and Follow-up of Carotid Cavernous Sinus Fistulas

This report describes color doppler imaging (CDI) in theevaluation and follow-up of nine patients with carotid cavernous sinusfistulas.The orbits and carotid arteries were examined with CDI.In allcases,the diagnosis was confirmed by angiography.CDI clearlydemonstrated the dilated superior ophthalmic veins (SOVs) with retrogradeflow and low resistance arterial doppler waveform in all nine patients (10eyes).After the study of quantitative hemodynamics,we found that directcarotid cavernous sinus fistulas showed a high-velocity blood flow in theabnormal SOVs in all seven patients and a very low resistance,high flowvolume circulation in the involved internal carotid artery (ICA) in six patientsthat had been examined; however,two patients with dural cavernous sinusfistulas had a lower blood flow in the SOVs than direct fistulas and nosignificant hemodynamic changes were found between the ipsilateral ICAand the contralateral ICA.These results were helpful for the diagnosis andthe differential diagnosis between direct fistulas and dural fistulas.CDI alsoprovides a convenient way to track the natural history and response totreatment of these arteriovenous fistulas.CDI offer several advantages,namely noninvasive and can be performed easily,quickly,inexpensively andreproducibly.Eye Science 1993;9:153-157.