超声与磁共振成像测量视神经鞘直径诊断颅内压升高：一项系统综述和荟萃分析。

IF 1.8 4区医学 Q2 ACOUSTICS

Medical Ultrasonography Pub Date : 2023-09-29 Epub Date: 2023-06-22 DOI:10.11152/mu-4037

Nan Xu, Qiang Zhu

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引用次数: 1

摘要

目的：比较眼部超声（US）和磁共振成像（MRI）测量的视神经鞘直径（ONSD）对颅内压升高（ICP）诊断的准确性。材料和方法：系统检索评价US或MRI ONSD诊断ICP升高的研究。数据由两位作者独立提取。我们使用双变量随机效应模型来评估在ICP增加的患者中测量ONSD的诊断可行性。采用总结受试者工作特性（SROC）图来计算灵敏度和特异性。结果：共纳入31项研究，其中1783例诊断为US ONSD，730例诊断为MRI ONSD。20项报告US ONSD的研究被纳入定量合成。US ONSD具有较高的诊断准确性，估计灵敏度为0.92（95%CI 0.87-0.95），估计特异性为0.85（95%CI 0.79-0.89），阳性似然比（PLR）为6.0（95%CI 4.3-8.4），阴性似然比（NLR）为0.10（95%CI 0.06-0.15），诊断比值比（DOR）为62（95%CI 33-117）。收集了11项采用MRI ONSD的研究的数据。MRI ONSD显示估计的敏感性为0.70（95%CI 0.60-0.78），估计的特异性为0.85（95%CI 0.80-0.90），PLR为4.8（95%CI 3.4-6.7），NLR为0.35（95%CI 0.27-0.47），DOR为13（95%CI 8-22）。亚组分析显示，US ONSD显示出更高的灵敏度（0.92对0.70；P结论：测量ONSD可以作为预测ICP升高的有用工具。US ONSD在诊断ICP升高方面比MRI ONSD显示更准确。

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Optic nerve sheath diameter measured by ultrasonography versus Magnetic Resonance Imaging for diagnosing increased intracranial pressure: a systematic review and meta-analysis.

Aims: To compare the accuracy of the optic nerve sheath diameter (ONSD) measured by ocular ultrasonography (US) versus magnetic resonance imaging (MRI) for the diagnosis of increased intracranial pressure (ICP).

Material and methods: A systematic search of studies evaluating US ONSD or MRI ONSD for the diagnosis of increased ICP was performed. Data were extracted independently by two authors. We used the bivariate random-effects model to evaluate the diagnostic feasibility of measuring the ONSD in patients increased ICP. A summary receiver operating characteristic (SROC) graph was adopted to calculate sensitivity and specificity. Subgroup analysis was used to explore potential difference in US ONSD and MRI ONSD.

Results: A total of 31 studies were included, in which there were 1783 patients diagnosed with US ONSD and 730 patients diagnosed with MRI ONSD. Twenty studies reporting US ONSD were included for quantitative synthesis. The US ONSD had a high diagnostic accuracy, involving estimated sensitivity of 0.92 (95%CI 0.87-0.95), estimated specificity of 0.85 (95%CI 0.79-0.89), positive likelihood ratio (PLR) of 6.0 (95%CI 4.3-8.4), negative likelihood ratio (NLR) of 0.10 (95%CI 0.06-0.15) and Diagnostic Odds Ratio (DOR) of 62 (95%CI 33-117). The data of 11 studies adopting MRI ONSD was pooled. The MRI ONSD demonstrated estimated sensitivity of 0.70 (95%CI 0.60-0.78), estimated specificity of 0.85 (95%CI 0.80-0.90), PLR of 4.8 (95%CI 3.4-6.7), NLR of 0.35 (95%CI 0.27-0.47) and DOR of 13 (95%CI 8-22). The subgroup analysis showed that US ONSD demonstrated a higher sensitivity (0.92 versus 0.70; p<0.01) and almost equal specificity (0.85 vs. 0.85; p=0.67) compared with MRI ONSD.

Conclusion: Measurement of ONSD can be a useful tool to predict raised ICP. The US ONSD demonstrated better accuracy than MRI ONSD for the diagnosis of increased ICP.

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来源期刊

Medical Ultrasonography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

3.20

自引率

5.90%

发文量

期刊介绍： The journal aims to promote ultrasound diagnosis by publishing papers in a variety of categories, including editorial letters, original papers, review articles, pictorial essays, technical developments, case reports, letters to the editor or occasional special reports (fundamental, clinical as well as methodological and educational papers). The papers published cover the whole spectrum of the applications of diagnostic medical ultrasonography, including basic science and therapeutic applications. The journal hosts information regarding the society''s activities, scheduling of accredited training courses in ultrasound diagnosis, as well as the agenda of national and international scientific events.