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Improved diagnostic value of a TCD-based non-invasive ICP measurement method compared with the sonographic ONSD method for detecting elevated intracranial pressure.
Neurol Res 2014; 36(7):607-14NR

Abstract

OBJECTIVES

To compare the diagnostic reliability of optic nerve sheath diameter (ONSD) ultrasonography with a transcranial Doppler (TCD)-based absolute intracranial pressure (ICP) value measurement method for detection of elevated ICP in neurological patients. The ONSD method has been only tested previously on neurosurgical patients.

METHODS

A prospective clinical study of a non-invasive ICP estimation method based on ONSD correlation with ICP and an absolute ICP value measurement method based on a two-depth TCD technology has recruited 108 neurological patients. Ninety-two of these patients have been enrolled in the final analysis of the diagnostic reliability of ONSD ultrasonography and 85 patients using the absolute ICP value measurement method. All non-invasive ICP measurements were compared with 'Gold Standard' invasive cerebrospinal fluid (CSF) pressure measurements obtained by lumbar puncture. Receiver-operating characteristic (ROC) analysis has been used to investigate the diagnostic value of these two methods.

RESULTS

The diagnostic sensitivity, specificity, and the area under the ROC curve (AUC) of the ONSD method for detecting elevated intracranial pressure (ICP >14·7 mmHg) were calculated using a cutoff point of ONSD at 5·0 mm and found to be 37·0%, 58·5%, and 0·57, respectively. The diagnostic sensitivity, specificity, and AUC for the non-invasive absolute ICP measurement method were calculated at the same ICP cutoff point of 14·7 mmHg and were determined to be 68·0%, 84·3%, and 0·87, respectively.

CONCLUSIONS

The non-invasive ICP measurement method based on two-depth TCD technology has a better diagnostic reliability on neurological patients than the ONSD method when expressed by the sensitivity and specificity for detecting elevated ICP >14·7 mmHg.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24620972

Citation

Ragauskas, Arminas, et al. "Improved Diagnostic Value of a TCD-based Non-invasive ICP Measurement Method Compared With the Sonographic ONSD Method for Detecting Elevated Intracranial Pressure." Neurological Research, vol. 36, no. 7, 2014, pp. 607-14.
Ragauskas A, Bartusis L, Piper I, et al. Improved diagnostic value of a TCD-based non-invasive ICP measurement method compared with the sonographic ONSD method for detecting elevated intracranial pressure. Neurol Res. 2014;36(7):607-14.
Ragauskas, A., Bartusis, L., Piper, I., Zakelis, R., Matijosaitis, V., Petrikonis, K., & Rastenyte, D. (2014). Improved diagnostic value of a TCD-based non-invasive ICP measurement method compared with the sonographic ONSD method for detecting elevated intracranial pressure. Neurological Research, 36(7), pp. 607-14. doi:10.1179/1743132813Y.0000000308.
Ragauskas A, et al. Improved Diagnostic Value of a TCD-based Non-invasive ICP Measurement Method Compared With the Sonographic ONSD Method for Detecting Elevated Intracranial Pressure. Neurol Res. 2014;36(7):607-14. PubMed PMID: 24620972.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improved diagnostic value of a TCD-based non-invasive ICP measurement method compared with the sonographic ONSD method for detecting elevated intracranial pressure. AU - Ragauskas,Arminas, AU - Bartusis,Laimonas, AU - Piper,Ian, AU - Zakelis,Rolandas, AU - Matijosaitis,Vaidas, AU - Petrikonis,Kestutis, AU - Rastenyte,Daiva, Y1 - 2014/01/12/ PY - 2014/3/14/entrez PY - 2014/3/14/pubmed PY - 2015/1/27/medline KW - Absolute intracranial pressure, KW - Diagnostic reliability, KW - Doppler technology, KW - Non-invasive measurement, KW - Optic nerve sheath diameter SP - 607 EP - 14 JF - Neurological research JO - Neurol. Res. VL - 36 IS - 7 N2 - OBJECTIVES: To compare the diagnostic reliability of optic nerve sheath diameter (ONSD) ultrasonography with a transcranial Doppler (TCD)-based absolute intracranial pressure (ICP) value measurement method for detection of elevated ICP in neurological patients. The ONSD method has been only tested previously on neurosurgical patients. METHODS: A prospective clinical study of a non-invasive ICP estimation method based on ONSD correlation with ICP and an absolute ICP value measurement method based on a two-depth TCD technology has recruited 108 neurological patients. Ninety-two of these patients have been enrolled in the final analysis of the diagnostic reliability of ONSD ultrasonography and 85 patients using the absolute ICP value measurement method. All non-invasive ICP measurements were compared with 'Gold Standard' invasive cerebrospinal fluid (CSF) pressure measurements obtained by lumbar puncture. Receiver-operating characteristic (ROC) analysis has been used to investigate the diagnostic value of these two methods. RESULTS: The diagnostic sensitivity, specificity, and the area under the ROC curve (AUC) of the ONSD method for detecting elevated intracranial pressure (ICP >14·7 mmHg) were calculated using a cutoff point of ONSD at 5·0 mm and found to be 37·0%, 58·5%, and 0·57, respectively. The diagnostic sensitivity, specificity, and AUC for the non-invasive absolute ICP measurement method were calculated at the same ICP cutoff point of 14·7 mmHg and were determined to be 68·0%, 84·3%, and 0·87, respectively. CONCLUSIONS: The non-invasive ICP measurement method based on two-depth TCD technology has a better diagnostic reliability on neurological patients than the ONSD method when expressed by the sensitivity and specificity for detecting elevated ICP >14·7 mmHg. SN - 1743-1328 UR - https://www.unboundmedicine.com/medline/citation/24620972/Improved_diagnostic_value_of_a_TCD_based_non_invasive_ICP_measurement_method_compared_with_the_sonographic_ONSD_method_for_detecting_elevated_intracranial_pressure_ L2 - http://www.tandfonline.com/doi/full/10.1179/1743132813Y.0000000308 DB - PRIME DP - Unbound Medicine ER -