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Use of neuroimaging measurements of optic nerve sheath diameter to assess intracranial pressure in craniosynostosis.
Childs Nerv Syst. 2018 05; 34(5):939-946.CN

Abstract

PURPOSE

This study aims to evaluate accuracy of optic nerve sheath diameter (ONSD) measurements obtained by magnetic resonance imaging (MRI) in patients with craniosynostosis (CS) for detection of high intracranial pressure (ICP) and to correlate MRI-derived ONSD measurements with those obtained by computed tomography (CT) scans in CS patients.

METHODS

A retrospective review was conducted on CS patients who had MRI- and age-matched controls with normal MRI. Diagnosis of intracranial hypertension was based on presence of papilledema, direct ICP monitoring, and/or lumbar puncture. The search also included patients with MRI and CT done within 30 days apart. ONSDs were measured 3 mm behind the globe on both modalities.

RESULTS

The study identified 56 CS patients (mean age 3.8 ± 3.47 years) and 49 controls (mean age 3.7 ± 3.62 years). Mean ONSD in patients with high ICP was significantly higher than in patients without high ICP (P = 0.0001) and in controls (P < 0.0001). The optimal ONSD threshold for predicting raised ICP in patients >1 year old was 6 mm (71.4% sensitivity, 89.7% specificity). Nineteen patients with 38 single-eye MRI/CT pairs were identified. Substantial agreement between both modalities resulted (r = 0.959, 95% CI 0.923-0.978), and Bland and Altman Plot analysis showed that 95% of measurements fell within limits of agreement (1.96 SD; ± 0.6 mm).

CONCLUSION

In CS patients, ONSD measured by MRI represent indirect non-invasive means of ICP assessment. Both MRI and CT measurements of ONSD gave comparable results, and the use of CT-derived ONSD measurements may give some idea about ICP in CS patients.

Authors+Show Affiliations

Department of Plastic Surgery - Cleft-Craniofacial Center, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, 15224, USA. mostafaharedy84@gmail.com. Plastic Surgery Department - Cleft and Craniofacial Unit, Sohag University Hospital, Sohag, 82524, Egypt. mostafaharedy84@gmail.com.Department of Radiology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.Department of Neurosurgery, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.Department of Ophthalmology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.Department of Ophthalmology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.Department of Plastic Surgery - Cleft-Craniofacial Center, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, 15224, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29380112

Citation

Haredy, Mostafa, et al. "Use of Neuroimaging Measurements of Optic Nerve Sheath Diameter to Assess Intracranial Pressure in Craniosynostosis." Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery, vol. 34, no. 5, 2018, pp. 939-946.
Haredy M, Zuccoli G, Tamber M, et al. Use of neuroimaging measurements of optic nerve sheath diameter to assess intracranial pressure in craniosynostosis. Childs Nerv Syst. 2018;34(5):939-946.
Haredy, M., Zuccoli, G., Tamber, M., Davis, A., Nischal, K., & Goldstein, J. A. (2018). Use of neuroimaging measurements of optic nerve sheath diameter to assess intracranial pressure in craniosynostosis. Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery, 34(5), 939-946. https://doi.org/10.1007/s00381-018-3728-7
Haredy M, et al. Use of Neuroimaging Measurements of Optic Nerve Sheath Diameter to Assess Intracranial Pressure in Craniosynostosis. Childs Nerv Syst. 2018;34(5):939-946. PubMed PMID: 29380112.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of neuroimaging measurements of optic nerve sheath diameter to assess intracranial pressure in craniosynostosis. AU - Haredy,Mostafa, AU - Zuccoli,Giulio, AU - Tamber,Mandeep, AU - Davis,Amani, AU - Nischal,Ken, AU - Goldstein,Jesse A, Y1 - 2018/01/29/ PY - 2017/10/23/received PY - 2018/01/16/accepted PY - 2018/1/31/pubmed PY - 2019/9/3/medline PY - 2018/1/31/entrez KW - Computed tomography KW - Craniosynostosis KW - Intracranial hypertension KW - Magnetic resonance imaging KW - Optic nerve sheath diameter SP - 939 EP - 946 JF - Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery JO - Childs Nerv Syst VL - 34 IS - 5 N2 - PURPOSE: This study aims to evaluate accuracy of optic nerve sheath diameter (ONSD) measurements obtained by magnetic resonance imaging (MRI) in patients with craniosynostosis (CS) for detection of high intracranial pressure (ICP) and to correlate MRI-derived ONSD measurements with those obtained by computed tomography (CT) scans in CS patients. METHODS: A retrospective review was conducted on CS patients who had MRI- and age-matched controls with normal MRI. Diagnosis of intracranial hypertension was based on presence of papilledema, direct ICP monitoring, and/or lumbar puncture. The search also included patients with MRI and CT done within 30 days apart. ONSDs were measured 3 mm behind the globe on both modalities. RESULTS: The study identified 56 CS patients (mean age 3.8 ± 3.47 years) and 49 controls (mean age 3.7 ± 3.62 years). Mean ONSD in patients with high ICP was significantly higher than in patients without high ICP (P = 0.0001) and in controls (P < 0.0001). The optimal ONSD threshold for predicting raised ICP in patients >1 year old was 6 mm (71.4% sensitivity, 89.7% specificity). Nineteen patients with 38 single-eye MRI/CT pairs were identified. Substantial agreement between both modalities resulted (r = 0.959, 95% CI 0.923-0.978), and Bland and Altman Plot analysis showed that 95% of measurements fell within limits of agreement (1.96 SD; ± 0.6 mm). CONCLUSION: In CS patients, ONSD measured by MRI represent indirect non-invasive means of ICP assessment. Both MRI and CT measurements of ONSD gave comparable results, and the use of CT-derived ONSD measurements may give some idea about ICP in CS patients. SN - 1433-0350 UR - https://www.unboundmedicine.com/medline/citation/29380112/Use_of_neuroimaging_measurements_of_optic_nerve_sheath_diameter_to_assess_intracranial_pressure_in_craniosynostosis_ L2 - https://doi.org/10.1007/s00381-018-3728-7 DB - PRIME DP - Unbound Medicine ER -