Color Doppler imaging. A new noninvasive technique to diagnose and monitor carotid cavernous sinus fistulas
P. M. Flaharty, W. E. Lieb, R. C. Sergott, T. M. Bosley and P. J. Savino
Neuro-ophthalmology Service, Wills Eye Hospital, Philadelphia, PA 19107.
Color Doppler imaging is a recent development in ultrasonography that
allows for simultaneous two-dimensional structural imaging and Doppler
evaluation of blood flow. With this technique, one patient with a traumatic
carotid cavernous sinus fistula and two patients with spontaneous dural
cavernous arteriovenous malformations were evaluated. Color Doppler imaging
demonstrated a dilated superior ophthalmic vein with arterialized blood
flow in all three patients. In two cases the diagnosis was confirmed by
angiography, and in one of these cases the fistula was occluded with a
detachable balloon catheter. Postembolization color Doppler imaging
revealed return of normal venous flow in the superior ophthalmic vein. This
technique offers a noninvasive means to confirm the clinical diagnosis and
to track the hemodynamics of these arteriovenous fistulas. In certain
cases, color Doppler imaging may eliminate the need for computed tomography
and magnetic resonance imaging in the evaluation of suspected arteriovenous
malformations of the orbit.
