[Application of transcranial color Doppler flow imaging in the carotid cavernous sinus fistulae].

Transcranial color Doppler flow imaging (TCCDFI) allows for simultaneous two-dimensional structural imaging and Doppler evaluation of blood flow through intact skull. With this technique, we evaluated 10 patients with carotid cavernous sinus fistulae (CCSF) and 35 normal volunteers. Each of them was confirmed by angiography. TCCDFI showed that patients with CCSF had typical signs in the affected part. The cavernous sinus had mosaic color shade. Pulse-Doppler showed disorderly polydirection vortex blood flow spectra in the mosaic color shade associated with murmur. Two-dimensional sonography and color Doppler imaging demonstrated a dilated superior ophthalmic vein (SOV) with arterialized blood flow. The Vmax of MCA and ACA in the affected side were lower than the healthy and normal side. The RI was lower than that of the healthy side and PCA of both sides was lower than that in normal volunteers. Two patients were examined after tubolization. Mosaic color shade disappeared and SOV returned to normal venous flow in patients completely occluded. Mosaic color shade reduced and SOV still aterialized blood flow in partly occluded patients. This technique helps to confirm the clinical diagnosis and to track the hemodynamics of CCSF patients and evaluate the effect of therapy.