经颅彩色多普勒血流显像诊断颈动脉海绵窦瘘的临床价值

Clinical value of the diagnosis of carotid-cavernous sinus fistula with transcranial color Doppler sonography

目的:评价经颅彩色多普勒血流显像(TCCS)诊断颈动脉海绵窦瘘的临床应用价值。方法:本组9例颈动脉海绵窦瘘经脑血管造影证实。采用经颅彩色多普勒血流显像通过颞窗和眶窗进行扫查。沿颈内动脉颅内段走行仔细探查海绵窦瘘的异常彩色血流团测量颈内动脉、颈外动脉和眼上静脉的血流频谱。结果:9例颈动脉海绵窦瘘中7例(A型)经颅超声可明确诊断(78%),I(D型)例可疑诊断(11%),I(B型)例漏诊(11%)。确诊的7例均可探及明显的海绵窦瘘彩色血流影,患侧颈内动脉呈高速低阻血流频谱,眼上静脉血流速度亦显著加快。结论:经颅彩色多普勒血流显像对A型颈动脉海绵窦瘘具有较高的临床应用价值。

Objective： To evaluate clinical value of transcranial color Doppler sonography （TCCS） in the diagnosis of carotid-cavernous sinus fistula. Methods：9 cases of carotid-cavemous fistula demonstrated by digital subtractison angiography were involved in this study. Transcranial color Doppler sonography was performed through temporal and occipital acoustic windows. A mosaic flash of carotid-cavernous fistula was carefully detected and the corresponding sonographic spectrum of intemal carotid artery, external carotid artery and superior ophthalmic vein was measured. Results： 7 cases（type A） of carotid cavemous fistula were definitely diagnosed by TCCS due to their characteristic sonographic signs such as mosaic flash, pattern of high-velocity and lower resistence in internal carotid artery, engorged superior ophthalmic vein： 1 case （type D） was suspectedly diagnosed, 1 case（type B） was missed. Conclusion：TCDS has a high diagnostic accuracy to type A uarotid-cavernous fistula.