Comparison Between Ultrasound and Magnetic Resonance Imaging Measurements of the Optic Nerve Sheath Diameter in Patients Undergoing Intracranial Surgery: Prospective Observational Single-Center Study.

Abstract

Background: Measuring the optic nerve sheath diameter (ONSD) with ultrasound is a promising, noninvasive way to estimate intracranial pressure (ICP). While magnetic resonance imaging (MRI) provides high-resolution imaging, it is less accessible in urgent or perioperative settings. Comparing ONSD measurements between ultrasound and MRI may help confirm the use of ultrasound in neurosurgical patients.

Objective: The aim of this study is to evaluate how closely ultrasound and MRI measurements of ONSD align in patients undergoing surgery for supratentorial brain tumors.

Methods: This prospective, single-center observational study included 50 adult patients scheduled for elective supratentorial tumor resection. ONSD was measured preoperatively using both transorbital ultrasound and MRI. Measurements were compared using Pearson and Spearman correlation coefficients, the intraclass correlation coefficient, and Bland-Altman analysis.

Results: The average ONSD measured by ultrasound was 5.94 (0.99) mm, compared to 5.75 (SD 1.08) mm via MRI. The two methods showed a strong correlation (Pearson r=0.88, P<.001) and good agreement (intraclass correlation coefficient=0.86). Bland-Altman analysis showed a mean bias of 0.19 mm (95% limits of agreement: -0.62 to 1.00 mm).

Conclusions: Ultrasound-based ONSD measurements closely matched those obtained by MRI in this patient group. These findings support the use of ultrasound as a practical tool for noninvasive ICP assessment in the perioperative care of patients with intracranial tumors.