A prospective study of transorbital ultrasound multimodal imaging in the detection and evaluation of increased intracranial pressure.

IF 3.2 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

BMC Medical Imaging Pub Date : 2025-08-26 DOI:10.1186/s12880-025-01893-w

Peng He, Lanlan Yu, Xingheng Wang, Bo Ren, Peng Gu, Fei Yang, Yuan Zou

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引用次数: 0

Abstract

Background: To develop and validate a multimodal transorbital ultrasound model for noninvasive detection of increased intracranial pressure (IICP) by integrating anatomical and hemodynamic parameters.

Methods: In this prospective diagnostic study, 136 neurology patients scheduled for lumbar puncture underwent pre-procedural ultrasound measurement of optic nerve sheath diameter (ONSD), ONSD-to-eyeball transverse diameter ratio (ONSD/ETD), and central retinal artery hemodynamics (peak systolic velocity [PSV], resistance index [RI]). Patients were classified as IICP (CSF pressure > 200 mmH₂O) or normal ICP (NICP) groups. Parameter performance was analyzed via ROC curves; multivariate logistic regression constructed a predictive model.

Results: The IICP group (n = 52) showed significantly higher ONSD (5.06 ± 0.49 vs. 4.19 ± 0.82 mm), ONSD/ETD (0.24 ± 0.02 vs.0.19 ± 0.04), and RI (0.66 ± 0.07vs.0.56 ± 0.09) but lower PSV (9.45 ± 1.38 vs.10.86 ± 2.14 cm/s) versus NICP (n = 84) (all P < 0.001). The integrated model (ONSD + ONSD/ETD + PSV + RI) achieved superior diagnostic accuracy: AUC 0.95 (95% CI: 0.922-0.988), sensitivity 88.1%, specificity 98.0%, Youden's index 0.86-significantly outperforming any single parameter (AUC 0.67-0.87, P < 0.001)-with the predictive equation: Logit(P) = 1.94×ONSD-84.6×ONSD/ETD + 0.79×PSV-3.8×RI + 11.05.

Conclusion: Transorbital multimodal ultrasound combining structural and vascular parameters enables highly accurate, rapid IICP screening, offering a clinically viable noninvasive alternative to conventional monitoring.

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经眶超声多模态成像检测和评价颅内压增高的前瞻性研究。

背景：通过整合解剖学和血流动力学参数，建立并验证一种多模态经眶超声模型，用于无创检测颅内压升高（IICP）。方法：在这项前瞻性诊断研究中，136例神经内科患者计划行腰椎穿刺，术前超声测量视神经鞘直径（ONSD）、视神经鞘与眼球横径比（ONSD/ETD）和视网膜中央动脉血流动力学（峰值收缩速度[PSV]、阻力指数[RI]）。将患者分为IICP （CSF pressure > ~ 200mmh₂O）组和正常ICP （NICP）组。通过ROC曲线分析参数性能；多元逻辑回归构建了预测模型。结果：IICP组（n = 52）的ONSD（5.06±0.49 vs. 4.19±0.82 mm）、ONSD/ETD（0.24±0.02 vs.0.19±0.04）和RI（0.66±0.07vs.0.56±0.09）显著高于NICP组（n = 84）， PSV（9.45±1.38 vs.10.86±2.14 cm/s）显著低于NICP组（均为P）。结论：经眶多模态超声结合结构和血管参数可实现高度准确、快速的IICP筛查，为常规监测提供了临床可行的无创替代方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Medical Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.60

自引率

3.70%

发文量

198

审稿时长

27 weeks

期刊介绍： BMC Medical Imaging is an open access journal publishing original peer-reviewed research articles in the development, evaluation, and use of imaging techniques and image processing tools to diagnose and manage disease.