Diagnosis and follow-up study of carotid cavernous fistulas with color doppler ultrasonography: Analysis of 33 cases

Abstract

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