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VOLUME 19 , ISSUE 8 ( 2015 ) > List of Articles

RESEARCH ARTICLE

Correlation of measurement of optic nerve sheath diameter using ultrasound with magnetic resonance imaging

Kartik Munta, Chetan G. Shirodkar, S. Manimala Rao, M. Uma Mahesh

Keywords : Intensive Care Unit, magnetic resonance imaging, ocular sonography, optic nerve sheath diameter, raised intracranial pressure

Citation Information : Munta K, Shirodkar CG, Rao SM, Mahesh MU. Correlation of measurement of optic nerve sheath diameter using ultrasound with magnetic resonance imaging. Indian J Crit Care Med 2015; 19 (8):466-470.

DOI: 10.4103/0972-5229.162465

License: CC BY-ND 3.0

Published Online: 01-08-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background and Aims: Analysis to correlate the measurements of optic nerve sheath diameter (ONSD) obtained by using ultrasound to magnetic resonance imaging (MRI) techniques in order to establish the accuracy of ocular sonography as a noninvasive modality for detecting raised intracranial pressure (ICP). Materials and Methods: A prospective, observational study was performed in 100 cases of adult meningoencephalitis patients admitted to Intensive Care Unit in whom MRI was performed for neurodiagnosis. ONSD was measured in such patients, 3 mm behind the globe in each eye. A mean binocular ONSD >4.6 mm in female and 4.8 mm in male was taken as cut-off values for diagnosing raised ICP. This was compared with ONSD measured on T2-weighted MRI image measured 3 mm behind the globe. The reading obtained from both the methods were compared with Bland-Altman analysis for correlation and the findings were tabulated. Results: The mean ONSD values measured with ultrasonography (USG) and MRI for female were 5.48 ± 0.43 mm and 5.68 ± 0.44 mm and for male were 5.40 ± 0.37 mm and 5.56 ± 0.38 mm, respectively. The mean age of the female and male was 53.90 ± 17.84 and 56.06 ± 15.67 years, respectively. On comparing ultrasound with MRI-derived ONSD values, we found acceptable agreement between both methods for measurements at a depth of 3 mm (r = 0.02, P < 0.001). Conclusion: In our study, we have found a good correlation between ocular USG and MRI of ONSD. The study has shown agreement with the fact that ocular sonography can be used as a noninvasive tool for detecting raised ICP with accuracy.


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  1. Bäuerle J, Nedelmann M. Sonographic assessment of the optic nerve sheath in idiopathic intracranial hypertension. J Neurol 2011;258:2014-9.
  2. Geeraerts T, Merceron S, Benhamou D, Vigué B, Duranteau J. Non-invasive assessment of intracranial pressure using ocular sonography in neurocritical care patients. Intensive Care Med 2008;34:2062-7.
  3. Geeraerts T, Newcombe VF, Coles JP, Abate MG, Perkes IE, Hutchinson PJ, et al. Use of T2-weighted magnetic resonance imaging of the optic nerve sheath to detect raised intracranial pressure. Crit Care 2008;12:R114.
  4. Killer HE, Jaggi GP, Flammer J, Miller NR, Huber AR, Mironov A. Cerebrospinal fluid dynamics between the intracranial and the subarachnoid space of the optic nerve. Is it always bidirectional? Brain 2007;130(Pt 2):514-20.
  5. Hansen HC, Helmke K. Validation of the optic nerve sheath response to changing cerebrospinal fluid pressure: Ultrasound findings during intrathecal infusion tests. J Neurosurg 1997;87:34-40.
  6. Newton CR, Crawley J, Sowumni A, Waruiru C, Mwangi I, English M, et al. Intracranial hypertension in Africans with cerebral malaria. Arch Dis Child 1997;76:219-26.
  7. Calvo A, Hernández P, Spagnuolo E, Johnston E. Surgical treatment of intracranial hypertension in encephalic cryptococcosis. Br J Neurosurg 2003;17:450-5.
  8. Beckmann U, Gillies DM, Berenholtz SM, Wu AW, Pronovost P. Incidents relating to the intra-hospital transfer of critically ill patients. An analysis of the reports submitted to the Australian Incident Monitoring Study in Intensive Care. Intensive Care Med 2004;30:1579-85.
  9. Helmke K, Hansen HC. Fundamentals of transorbital sonographic evaluation of optic nerve sheath expansion under intracranial hypertension II. Patient study. Pediatr Radiol 1996;26:706-10.
  10. Dubourg J, Javouhey E, Geeraerts T, Messerer M, Kassai B. Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: A systematic review and meta-analysis. Intensive Care Med 2011;37:1059-68.
  11. Dubost C, Le Gouez A, Jouffroy V, Roger-Christoph S, Benhamou D, Mercier FJ, et al. Optic nerve sheath diameter used as ultrasonographic assessment of the incidence of raised intracranial pressure in preeclampsia: A pilot study. Anesthesiology 2012;116:1066-71.
  12. Rajajee V, Vanaman M, Fletcher JJ, Jacobs TL. Optic nerve ultrasound for the detection of raised intracranial pressure. Neurocrit Care 2011;15:506-15.
  13. Gangemi M, Cennamo G, Maiuri F, D′Andrea F. Echographic measurement of the optic nerve in patients with intracranial hypertension. Neurochirurgia (Stuttg) 1987;30:53-5.
  14. Hayreh SS. Pathogenesis of oedema of the optic disc (papilloedema). A preliminary report. Br J Ophthalmol 1964;48:522-43.
  15. Geeraerts T, Launey Y, Martin L, Pottecher J, Vigué B, Duranteau J, et al. Ultrasonography of the optic nerve sheath may be useful for detecting raised intracranial pressure after severe brain injury. Intensive Care Med 2007;33:1704-11.
  16. Kimberly HH, Shah S, Marill K, Noble V. Correlation of optic nerve sheath diameter with direct measurement of intracranial pressure. Acad Emerg Med 2008;15:201-4.
  17. Hansen HC, Helmke K. The subarachnoid space surrounding the optic nerves. An ultrasound study of the optic nerve sheath. Surg Radiol Anat 1996;18:323-8.
  18. Moretti R, Pizzi B. Optic nerve ultrasound for detection of intracranial hypertension in intracranial hemorrhage patients. Confirmation of previous findings in a different patient population. J Neurosurg Anesthesiol 2009;21:16-20.
  19. Shirodkar CG, Rao SM, Mutkule DP, Harde YR, Venkategowda PM, Mahesh MU. Optic nerve sheath diameter as a marker for evaluation and prognostication of intracranial pressure in Indian patients: An observational study. Indian J Crit Care Med 2014;18:728-34.
  20. Ozgen A, Aydingöz U. Normative measurements of orbital structures using MRI. J Comput Assist Tomogr 2000;24:493-6.
  21. Weigel M, Lagrèze WA, Lazzaro A, Hennig J, Bley TA. Fast and quantitative high-resolution magnetic resonance imaging of the optic nerve at 3.0 tesla. Invest Radiol 2006;41:83-6.
  22. Mashima Y, Oshitari K, Imamura Y, Momoshima S, Shiga H, Oguchi Y. High-resolution magnetic resonance imaging of the intraorbital optic nerve and subarachnoid space in patients with papilledema and optic atrophy. Arch Ophthalmol 1996;114:1197-203.
  23. Gass A, Barker GJ, Riordan-Eva P, MacManus D, Sanders M, Tofts PS, et al. MRI of the optic nerve in benign intracranial hypertension. Neuroradiology 1996;38:769-73.
  24. Brodsky MC, Vaphiades M. Magnetic resonance imaging in pseudotumor cerebri. Ophthalmology 1998;105:1686-93.
  25. Agid R, Farb RI, Willinsky RA, Mikulis DJ, Tomlinson G. Idiopathic intracranial hypertension: The validity of cross-sectional neuroimaging signs. Neuroradiology 2006;48:521-7.
  26. Steinborn M, Fiegler J, Ruedisser K, Hapfelmeier A, Denne C, Macdonald E, et al. Measurement of the optic nerve sheath diameter in children: Comparison between transbulbar sonography and magnetic resonance imaging. Ultraschall Med 2012;33:569-73.
  27. Steinborn M, Fiegler J, Kraus V, Denne C, Hapfelmeier A, Wurzinger L, et al. High resolution ultrasound and magnetic resonance imaging of the optic nerve and the optic nerve sheath: Anatomic correlation and clinical importance. Ultraschall Med 2011;32:608-13.
  28. Sekhon MS, McBeth P, Zou J, Qiao L, Kolmodin L, Henderson WR, et al. Association between optic nerve sheath diameter and mortality in patients with severe traumatic brain injury. Neurocrit Care 2014;21:245-52.
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