Orbital colour Doppler imaging in carotid-cavernous sinus fistula

Background: Colour Doppler imaging (CDI) is a recent advance in ultrasonography that allows for colour-encoded blood flow data of a vascular structure to be displayed simultaneously on a conventional real-time gray-scale B mode image. Real time A and B mode ultrasonography have been used for diagnostic evaluation of ophthalmic disorders since the early 1960s. The haemodynamic characteristics of the ophthalmic circulation have recently been studied by the use of CDI.
Method: We present three cases of carotid-cavernous sinus fistulas with different presentations. In each case, orbital CDI was used in evaluating the patient's condition.
Results: Orbital CDI was successful in confirming the diagnosis in all three cases. CDI was capable of showing the haemodynamic changes in the orbital vasculature which resulated from carotid-cavernous sinus fistula.
Conclusion: This non-invasive technique presents as an excellent alternative to invasive vascular studies such as angiography for the diagnosis and evaluation of carotid-cavernous sinus fistulas.