外伤整形及眼眶             623                                      PO0772

　　Superior ophthalmic vein enlargement associated with orbital arteriovenous malformation

　　程金伟，魏锐利，蔡季平，朱煌，李由

　　第二军医大学附属长征医院眼科  200003

　　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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