Imaging diagnosis of enlarged superior ophthalmic vein

To evaluate the diagnostic value of CT, MRI and Doppler ultrasound in dilatation of superior ophthalmic vein (SOV) and its etiologies.

One hundred and sixteen cases of enlarged SOV were analyzed with regard to imaging techniques.

SOV enlargement was noted to occur in carotid-cavernous fistula (92 cases), ophthalmic Graves' disease (14), Tolosa-Hunt syndrome (2), inflammation at the apex of the orbit (2), ocular vascular deformity (2), orbital pseudotumor (1), orbital hematoma (1), cavernous sinus tumor (1) and thrombosis of cavernous sinus (1). The dilated vein appeared as signal void tubular shadows on both T(1) and T(2) weighted images. The diameter of the enlarged vein was 3.5 - 7.0 mm. Extraocular muscle enlargement, orbital lesions, enlarged cavernous sinus, etc were also revealed by MRI, CT and B-ultrasound scan.

The dilated SOV may be well demonstrated by MRI, CT and ultrasound scanning. The etiological diagnosis of enlarged SOV can be made in combination with the associated findings. The authors suggest that some carotid-cavernous fistula cases be occluded by retrograde embolization via the SOV route.