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The diagnostic performance of ultrasonographic optic nerve sheath diameter and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure.
Clin Neurol Neurosurg. 2016 Feb; 141:82-8.CN

Abstract

OBJECTIVES

To assess the diagnostic accuracy of ultrasonographic optic nerve sheath diameter (ONSD) measurement and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure (ICP).

PATIENTS AND METHODS

A total 60 patients with (cases, n=30) and without (controls, n=30) acute clinical and computed tomographic findings of elevated ICP due to intracranial mass/hemorrhage were recruited from a teaching hospital. The mean binocular and maximum ultrasonographic ONSDs, as well as the mean binocular Doppler ultrasound waveform indices of the ophthalmic arteries including pulsatility index (PI), resistive index (RI), end-systolic velocity (ESV), peak systolic velocity (PSV) and end-diastolic velocity (EDV) were compared between the two groups.

RESULTS

Compared to controls, the case group had significantly higher mean binocular ONSD (5.48 ± 0.52 mm vs. 4.09 ± 0.22 mm, p<0.001), maximum ONSD (5.63 ± 0.55 mm vs. 4.16 ± 0.23 mm, p<0.001), mean PI (1.53 ± 0.16 vs. 1.45 ± 0.20, p=0.01), and mean RI (0.76 ± 0.07 vs. 0.73 ± 0.04, p=0.01). The mean EDV, in contrast, was significantly higher in controls (8.55 ± 3.09 m/s vs. 7.17 ± 2.61 m/s, p=0.01). The two groups were comparable for the mean PSV (30.73 ± 7.93 m/s in cases vs. 32.27 ± 10.39 m/s in controls, p=0.36). Among the mentioned variables, the mean binocular ONSD was the most accurate parameter in detecting elevated ICP (sensitivity and specificity of 100%, cut-off point=4.53 mm). The Doppler indices were only moderately accurate (sensitivity: 56.7-60%, specificity: 63.3-76.7%).

CONCLUSION

While the ultrasonographic mean binocular ONSD (>4.53 mm) was completely accurate in detecting elevated ICP, color Doppler indices of the ophthalmic arteries were of limited value.

Authors+Show Affiliations

Department of Radiology, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.Department of Radiology, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.Department of Neurosurgery, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: Fouladi.daniel@yahoo.com.Department of Radiology, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.Department of Radiology, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26771156

Citation

Tarzamni, Mohammad Kazem, et al. "The Diagnostic Performance of Ultrasonographic Optic Nerve Sheath Diameter and Color Doppler Indices of the Ophthalmic Arteries in Detecting Elevated Intracranial Pressure." Clinical Neurology and Neurosurgery, vol. 141, 2016, pp. 82-8.
Tarzamni MK, Derakhshan B, Meshkini A, et al. The diagnostic performance of ultrasonographic optic nerve sheath diameter and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure. Clin Neurol Neurosurg. 2016;141:82-8.
Tarzamni, M. K., Derakhshan, B., Meshkini, A., Merat, H., Fouladi, D. F., Mostafazadeh, S., & Rezakhah, A. (2016). The diagnostic performance of ultrasonographic optic nerve sheath diameter and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure. Clinical Neurology and Neurosurgery, 141, 82-8. https://doi.org/10.1016/j.clineuro.2015.12.007
Tarzamni MK, et al. The Diagnostic Performance of Ultrasonographic Optic Nerve Sheath Diameter and Color Doppler Indices of the Ophthalmic Arteries in Detecting Elevated Intracranial Pressure. Clin Neurol Neurosurg. 2016;141:82-8. PubMed PMID: 26771156.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The diagnostic performance of ultrasonographic optic nerve sheath diameter and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure. AU - Tarzamni,Mohammad Kazem, AU - Derakhshan,Babak, AU - Meshkini,Ali, AU - Merat,Hamid, AU - Fouladi,Daniel Fadaei, AU - Mostafazadeh,Samira, AU - Rezakhah,Amir, Y1 - 2015/12/15/ PY - 2015/10/08/received PY - 2015/12/02/revised PY - 2015/12/10/accepted PY - 2016/1/16/entrez PY - 2016/1/16/pubmed PY - 2016/10/27/medline KW - Color Doppler ultrasound KW - Intracranial pressure KW - Ophthalmic artery KW - Optic nerve sheath diameter KW - Ultrasonography SP - 82 EP - 8 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 141 N2 - OBJECTIVES: To assess the diagnostic accuracy of ultrasonographic optic nerve sheath diameter (ONSD) measurement and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure (ICP). PATIENTS AND METHODS: A total 60 patients with (cases, n=30) and without (controls, n=30) acute clinical and computed tomographic findings of elevated ICP due to intracranial mass/hemorrhage were recruited from a teaching hospital. The mean binocular and maximum ultrasonographic ONSDs, as well as the mean binocular Doppler ultrasound waveform indices of the ophthalmic arteries including pulsatility index (PI), resistive index (RI), end-systolic velocity (ESV), peak systolic velocity (PSV) and end-diastolic velocity (EDV) were compared between the two groups. RESULTS: Compared to controls, the case group had significantly higher mean binocular ONSD (5.48 ± 0.52 mm vs. 4.09 ± 0.22 mm, p<0.001), maximum ONSD (5.63 ± 0.55 mm vs. 4.16 ± 0.23 mm, p<0.001), mean PI (1.53 ± 0.16 vs. 1.45 ± 0.20, p=0.01), and mean RI (0.76 ± 0.07 vs. 0.73 ± 0.04, p=0.01). The mean EDV, in contrast, was significantly higher in controls (8.55 ± 3.09 m/s vs. 7.17 ± 2.61 m/s, p=0.01). The two groups were comparable for the mean PSV (30.73 ± 7.93 m/s in cases vs. 32.27 ± 10.39 m/s in controls, p=0.36). Among the mentioned variables, the mean binocular ONSD was the most accurate parameter in detecting elevated ICP (sensitivity and specificity of 100%, cut-off point=4.53 mm). The Doppler indices were only moderately accurate (sensitivity: 56.7-60%, specificity: 63.3-76.7%). CONCLUSION: While the ultrasonographic mean binocular ONSD (>4.53 mm) was completely accurate in detecting elevated ICP, color Doppler indices of the ophthalmic arteries were of limited value. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/26771156/The_diagnostic_performance_of_ultrasonographic_optic_nerve_sheath_diameter_and_color_Doppler_indices_of_the_ophthalmic_arteries_in_detecting_elevated_intracranial_pressure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(15)30094-9 DB - PRIME DP - Unbound Medicine ER -