Noninvasive and quantitative intracranial pressure estimation using ultrasonographic measurement of optic nerve sheath diameter.
We aimed to quantitatively assess intracranial pressure (ICP) using optic nerve sheath diameter (ONSD) measurements. We recruited 316 neurology patients in whom ultrasonographic ONSD was measured before lumbar puncture. They were randomly divided into a modeling and a test group at a ratio of 7:3. In the modeling group, we conducted univariate and multivariate analyses to assess associations between ICP and ONSD, age, sex, BMI, mean arterial blood pressure, diastolic blood pressure. We derived the mathematical function "Xing &Wang" from the modelling group to predict ICP and evaluated the function in the test group. In the modeling group, ICP was strongly correlated with ONSD (r = 0.758, p < 0.001), and this association was independent of other factors. The mathematical function was ICP = -111.92 + 77.36 × ONSD (Durbin-Watson value = 1.94). In the test group, a significant correlation was found between the observed and predicted ICP (r = 0.76, p < 0.001). Bland-Altman analysis yielded a mean difference between measurements of -0.07 ± 41.55 mmH2O. The intraclass correlation coefficient and its 95%CIs for noninvasive ICP assessments using our prediction model was 0.86 (0.79-0.90). Ultrasonographic ONSD measurements provide a potential noninvasive method to quantify ICP that can be conducted at the bedside.
Department of Neurology, The Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, China.
Li-Juan
LJ
Wang
Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China.
Yan
Y
Yao
Department of Neurology, The Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, China.
Liang-Shu
LS
Feng
Department of Neurology, The Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, China.
Yu-Zhi
YZ
Wang
Department of Neurology, The Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, China.
Nan-Nan
NN
Zheng
Department of Neurology, The Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, China.
Jia-Chun
JC
Feng
Department of Neurology, The Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, China.
Ying-Qi
YQ
Xing
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001794:Blood Pressure; D015992:Body Mass Index; D002561:Cerebrovascular Disorders / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003389:Cranial Nerve Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D051270:Headache Disorders, Primary / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D019586:Intracranial Hypertension / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007427:Intracranial Pressure; D008875:Middle Aged; D009900:Optic Nerve / Q000000981:diagnostic imaging*; D010523:Peripheral Nervous System Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013129:Spinal Puncture / Q000379:methods; D014463:Ultrasonography / Q000379:methods