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Combined accuracy of optic nerve sheath diameter, strain ratio, and shear wave elastography of the optic nerve in patients with idiopathic intracranial hypertension

Ultrasonography 2022년 41권 1호 p.106 ~ 113
Razek Ahmed Abdel Khalek Abdel, Elsaid Nada, Belal Tamer, Batouty Nihal, Azab Ahmed,
소속 상세정보
 ( Razek Ahmed Abdel Khalek Abdel ) - Mansoura Faculty of Medicine Department of Diagnostic Radiology
 ( Elsaid Nada ) - Mansoura Faculty of Medicine Department of Neurology
 ( Belal Tamer ) - Mansoura Faculty of Medicine Department of Neurology
 ( Batouty Nihal ) - Mansoura Faculty of Medicine Department of Diagnostic Radiology
 ( Azab Ahmed ) - Mansoura Faculty of Medicine Department of Neurology

Abstract


Purpose: This study assessed the combined accuracy of optic nerve sheath diameter (ONSD), strain ratio (SR), and shear wave elastography (SWE) of the optic nerve (ON) in patients with idiopathic intracranial hypertension (IIH).

Methods: This prospective study was carried out on both ONs of 34 consecutive patients diagnosed with IIH and 16 age- and sex-matched healthy volunteers. All of the study participants were women. The ONSD, SR, and SWE of the ON were measured. The severity of papilledema of IIH patients was sub-classified into mild papilledema and moderate/severe papilledema.

Results: The mean ONSD (5.6±1.1 mm), SR (0.7±0.1), and SWE (30.1±16.7 kPa) of the IIH patients were significantly different (P=0.001) from the ONSD (4.1±0.5 mm), SR (0.9±0.1), and SWE (8.2±3.4 kPa) of controls. The cutoff values of ONSD, SR, and SWE of the ON for differentiating IIH patients from controls were 5.45 mm, 0.8, and 10.3 kPa with areas under the curve (AUCs) of 0.91, 0.86, and 0.96 and accuracy values of 91%, 81%, and 93%, respectively. Combined SWE and ONSD and combined SWE, ONSD, and SR for differentiating IIH patients from controls revealed AUCs of 0.98 and 0.99 and accuracy values of 96% and 96%, respectively. ONSD, SR, and SWE showed significant differences between mild and moderate/severe papilledema (P=0.001). Papilledema was correlated with SWE (r=0.8, P=0.001), ONSD (r=0.4, P=0.001), and SR (r=-0.4, P=0.001).

Conclusion: The combination of ONSD, SR, and SWE may be helpful for diagnosing IIH, and a good indicator of the degree of papilledema.

키워드

Idiopathic intracranial hypertension; Optic nerve; Ultrasound elastography

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