Doppler mapping of direct carotid-cavernous fistulae (DCCF)

The aims of this study were to establish Doppler criteria for identifying d irect carotid-cavernous fistulae (DCCF), as well as the level of agreement between results obtained by Doppler mapping vs. angiography. Doppler mappin g and angiography were used to assess the direction of flow in the superior ophthalmic veins and the resistivity index in the internal carotid arterie s of 30 patients with DCCF, Both methods independently demonstrated reverse flow in superior ophthalmic vein ipsilateral to the DCCF in 22 patients an d normal flow in another four, The mean resistivity index for internal caro tid arteries with ipsilateral DCCF was significantly reduced (p = 0.0001) c ompared with that for contralateral internal carotid arteries without DCCF, A resistivity index value of < 0.495 offered a sensitivity and specificity of 86.6% in diagnosing ipsilateral DCCF, These findings suggest that a res istivity index < 0.495 in the ipsilateral internal carotid artery, with or without reverse how in the superior ophthalmic vein, is associated with a r easonable probability of diagnosing DCCF, <(c)> 2001 World Federation for U ltrasound in Medicine gr Biology.