Noninvasive and quantitative intracranial pressure estimation using ultrasonographic measurement of optic nerve sheath diameter

Li-Juan Wang, Yan Yao, Liang-Shu Feng, Yu-Zhi Wang, Nan-Nan Zheng, Jia-Chun Feng, Ying-Qi Xing, Li-Juan Wang, Yan Yao, Liang-Shu Feng, Yu-Zhi Wang, Nan-Nan Zheng, Jia-Chun Feng, Ying-Qi Xing

Abstract

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.

Conflict of interest statement

The authors declare no competing financial interests.

Figures

Figure 1. Flow diagram of the study.
Figure 1. Flow diagram of the study.
The terms “n” in the boxes represent the number of corresponding studies. ONSD = Optic nerve sheath diameter, ICP = intracranial pressure.
Figure 2. The measurement of optic nerve…
Figure 2. The measurement of optic nerve sheath diameter (ONSD).
ONSD measurement was assessed 3 mm behind the orbit. The ONSDs of patients with elevated intracranial pressures (ICPs) were significantly enlarged.
Figure 3
Figure 3
Figure 4
Figure 4

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