经颅彩色多普勒血流影像对颈内动胁－海绵窦瘘的临床诊断价值

A study for tbe applicalion of TCCDFI iu the CCSF

利用双功能彩色多普勒技术对１０例颈内动脉－海绵窦瘘及３５名脑血管造影正常者进行了观察分析。颈内动脉－海绵窦瘘患者经颅彩色多普勒血流影象（ＣＤＦＩ）检查，可见颈内动脉虹吸段有异常血流团影；脉冲多普勒检产可见异常血流团为多方向的杂乱的湍流频谱、并伴有吹风样杂音；患侧眼上静脉增宽，且血流方向逆转，呈动脉样低阻力血流频谱。３５名正常对照组无一人有异常表现。作者尚对２例患者进行了栓塞前后的观察，栓塞成功者ＣＤＦＩ检查以上表０现消失，而部分栓塞者仅表现为相同增益条件下异常血流团影缩小，且眼上静脉最大血流速度减低。结果表明，经颅ＣＤＦＩ是一种无创的颈内动脉－海绵窦瘘的诊断方法，且有准确、特异、方便等优点，并可用于术后疗效的评估。

ranscranial color Doppler flow imaging (TCCD-FD allows for simultaneous twodimentional structuralimaging and Doppler evaluation of blood flow throughintact skull. With this technique, we evaluated 10 pa-tients with carotid cavernous sinus fistulae (CCSF)and 35 normal volunteers. Each of them was con-firmed by angrography. TCCDFI showed that patientswith CCSF had typical signs in the affected part. Thecavernous sinus had mosaic color shade. Pulse-Dopplershowed disorderly polydirection vortex blcod flow spec-tra in the mosaic color shade associated with murmur.Two-dimentional sonography and. colorDoppler imag-ing demonstrated a dilated superior ophthamic vein(SOV) with arterialized blood flow. The Vmax ofMCA and ACA in the affected side were lower thanthe healthy and normal side. The RI was lower thanthat of the healthy side and PCA of both sides waslower than that in normal volunteers. Two patientswere examined after tubolization. Mosaic color shadedispeared and SOV returned to normal venous flow inpatients completely occluded. Mosaic color shade re-duced and StiV still aterialized blood flow in parly oc-cluded patients. This technique helps to confirm theclinical diagnosis and to track the hemodynarnics ofCCSF patients and evaluate the effect of therapy.