颈动脉海绵窦瘘的经颅多普勒超声研究

采用彩色三维经颅多普勒观察18例颈动脉海绵窦瘘血流情况，发现其引流静脉多以眼上静脉为主；患侧颈内动脉流速明显高于健侧；患侧MCA、ACA流速低于健侧。压迫患侧颈总动脉，患侧颈内动脉（瘘口以上）出现不同程度的倒灌血流。眼上静脉的动脉化且血流反向的频谱特点及患侧颈内动脉倒灌血流为颈内动脉海绵窦瘘的特征性表现。经眶窗检测颈内动脉虹吸段时，其流速受瘘口所在位置的影响，观察颅内盗血情况可粗略估价瘘口大小。经颅多普勒检测颈动脉海绵窦瘘还可了解患者Willis环代偿能力，为必要时行一侧颈内动脉闭塞提供参考依据。

Study of Carotid Cavernous Fistulae by Transcranial Doppler

We surveyed blood flow in 18 patients with carotid cavernous fistula (CCF) by color 3-dimensional transcranial dappler. Ophthalmic vein was played the key role for drainage. The velocity of the internal carotid artery was higher in affected side than normal side, but the velocity of the middle cerebral artery, anterior cerebral artery were lower than those of normal side. Pressing common carotid artery of affected side provoked reverse direction blood flow in different extent above the fistula orifice. The most typical outcome presented by TCD in CCF was that the arterilized ophthalmic vein maintained reverse direction flow and regurgitated flow of the internal carotid artery of affected side. When internal carotid siphon was investigated via orbital window, its velocity changed with the position of fistula orifice which can be estimated roughly by extent of intracranial stolen blood. By TCD, we can find out compensational capacity of Willis circle, that can give neuroradiologist an objective proof to obliterate one internal carotid artery if necessary.