Transorbital sonography in idiopathic intracranial hypertension: Single-center study, systematic review and meta-analysis

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging Pub Date : 2023-10-11 DOI:10.1111/jon.13160

Eleni Bakola, Lina Palaiodimou, Andreas Eleftheriou, Katerina Foska, Anastasia Pikouli, Maria Stefanatou, Maria Chondrogianni, Georgios Velonakis, Elissavet Andreadou, Marianna Papadopoulou, Theodoros Karapanayiotides, Christos Krogias, Chrysa Arvaniti, Georgios Tsivgoulis

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Abstract

Background and Purpose

Transorbital sonography (TOS) provides a noninvasive tool to detect intracranial pressure by assessing optic nerve sheath diameter (ONSD) and optic disc elevation (ODE). The utility of TOS in the diagnosis of idiopathic intracranial hypertension (IIH) has been increasingly recognized.

Methods

A single-center case-control study sought to compare TOS-acquired ONSD and ODE among IIH-cases versus patients with other neurological diseases (controls). Furthermore, a systematic review and meta-analysis was conducted to present pooled mean differences and diagnostic measures of ONSD and ODE between IIH-cases and controls.

Results

In the single-center study, consisting of 31 IIH-cases and 34 sex- and age-matched controls, ONSD values were higher among IIH-cases than controls (p<.001), while ODE was more prevalent in cases (65% vs. 15%; p<.001). The receiver-operating characteristic (ROC)-curve analysis revealed that the optimal cutoff value of ONSD for predicting IIH was 5.15 mm, with an area under the curve (AUC) of 0.914 (95% confidence interval [CI]: 0.861-0.967) and sensitivity and specificity values of 85% and 90%, respectively. In a meta-analysis of 14 included studies with 415 IIH-cases, ONSD and ODE values were higher in IIH-cases than controls (mean difference in ONSD 1.20 mm; 95% CI: 0.96-1.44 mm and in ODE 0.3 mm; 95% CI: 0.33-0.67 mm). With regard to ONSD, pooled sensitivity, specificity, and diagnostic odds ratio were calculated at 85.5% (95% CI: 77.9-90.8%), 90.7% (95% CI: 84.6-94.5%), and 57.394 (95% CI: 24.597-133.924), respectively. The AUC in summary ROC-curve analysis was 0.878 (95% CI: 0.858-0.899) with an optimal cutoff point of 5.0 mm.

Conclusions

TOS has a high diagnostic utility for the noninvasive diagnosis of IIH and may deserve wider implementation in everyday clinical practice.

Abstract Image

查看原文本刊更多论文

特发性颅内高压的经眶超声检查：单中心研究、系统综述和荟萃分析。

背景和目的：经眶超声（TOS）通过评估视神经鞘直径（ONSD）和视盘抬高（ODE），为检测颅内压提供了一种无创工具。TOS在特发性颅内高压（IIH）诊断中的作用越来越得到认可。方法：一项单中心病例对照研究试图比较IIH患者与其他神经系统疾病患者（对照组）的TOS获得性ONSD和ODE。此外，进行了一项系统综述和荟萃分析，以呈现IIH病例和对照组之间ONSD和ODE的汇总平均差异和诊断指标。结果：在由31例IIH病例和34名性别和年龄匹配的对照组组成的单中心研究中，IIH病例的ONSD值高于对照组（P结论：TOS对IIH的非侵入性诊断具有很高的诊断实用性，可能值得在日常临床实践中更广泛地实施。

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

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!