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Superior ophthalmic vein enlargement associated with orbital arteriovenous malformation         
Superior ophthalmic vein enlargement associated with orbital arteriovenous malformation
作者:程金伟,… 文章来源:第二军医大学长征医院眼科(200003) 点击数:1224 更新时间:2006/6/6 20:36:56
Aims―Superior ophthalmic vein (SOV) enlargement is an important image for carotid-carvenous sinus fistulas (CCFs), but not specific to CCF. Orbital arteriovenous malformations (AVMs) presenting with dilated SOV are reported. The radiologic, angiographic findings, and differential diagnosis are discussed. Methods―Six patients with orbital AVMs were reported in this article, with clinical symptoms and signs mimicking a cavernous sinus dural arteriovenous fistula. Examinations, such as computer tomography (CT), magnetic resonance imaging (MRI), and selective cerebral angiography, were done to find images and hemodynamics for differential diagnosis. Results―All patients were found with dilated SOV on CT and MRI. Additional radiographic findings included proptosis and AVMs. All six AVMs were located at the orbit, and one of them was also found with AVMs at brain. The main draining vein was SOV in all cases. The branches contributing to the fistula’s blood supply were the middle meningeal artery, the internal maxillary artery, and the ophthalmic artery. Conclusion―An orbital AVM can cause similar clinical signs and radiologic features to those associated with a CCF. However, the bulging cavernous sinus cannot be found in mostly AVMs. The conventional noninvasive techniques cannot delineate AVM arterial feeders or detect total draining veins. Hence, angiography remains necessary for definitive management. However, non-invasive techniques have an important role in pre-angiographic diagnostic decisions.
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