Massimo Venturini MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: With orbital CD, an accurate evaluation of the blood flow of the main orbital vessels can be obtained. In high-flow CCSF, several case reports showed dilatation and flow's modifications of Superior Ophthalmic Vein (S0V) with CD. Our aim was to evaluate, with CD and PD, all the main orbital vessels of a relative large number of patients affected by high-flow CCSF. Methods and Materials: Orbital blood flow of both eyes of 18 patients affected by high-flow CCSF and 20 healthy volunteers was compared. Patients were examined in supine position with closed eyelids. Superior ophthalmic vein (SOV), inferior ophthalmic vein (IOV), central retinal vein, central retinal artery, ophthalmic artery, long posterior ciliary artery were examined with CD (ATL HDI 5000 / 5-12 Mhz linear probe). The caliber of each vessel, the direction of blood flow and the following flow parameters were considered: maximum and minimum velocities for veins; peak systolic, end diastolic velocities and resistive index for arteries. PD was especially used to evaluate the blood flow of the IOV, characterized by a very low flow velocity. In some cases, Valsalva maneuver was necessary to identify the IOV. Results: In ipsilateral eyes (bilateral in 3 cases) affected by CCSF, CD showed all the SOV and 16/18 IOV with reversed, arterialized and low resistance blood flow (SOV dilated in 15/18 cases, IOV in 12/18). No significant differences were found considering the other vessels of ipsilateral eyes, controlateral eyes and normal subjects. Conclusion: CD and PD allow to accurately study all the main orbital vessels, also the IOV. In high-flow CCSF, not only the SOV but also the IOV are involved: CD can diagnose the presence of a CCSF also in case of SOV and IOV with a normal caliber (reversed, arterialized and low resistance blood flow). CD and PD can be also useful to non invasively monitor high-flow CCSF after an angiographic embolization.      

Venturini MD, M, Orbital Vessels Evaluation with Color-Doppler (CD) and Power-Doppler (PD) in High-flow Carotid Cavernous Sinus Fistulas (CCSF).  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3100925.html