Abstract：
OBJECTIVE: Invasive methods such as lumbar puncture and intraventricular catheters are commonly used to measure intracranial pressure (ICP). This study aims to develop quantitative and non-invasive techniques to measure ICP in patients with Idiopathic Intracranial Hypertension (IIH) using magnetic resonance imaging (MRI) findings.
METHODS: MRI data obtained from 50 patients with IIH and 30 age- and sex- matched controls were analyzed and optic nerve sheath diameter (ONSD), eyeball transverse diameter (ETD) and optic nerve diameter (OND) were measured. ONSD, ONSD/ETD and OND/ONSD indexes were calculated according to different ONSD measurement distances. Correlations of MRI findings with ICP were calculated. Sensitivity and specificity of all methods were analyzed.
RESULTS: ONSD and ONSD/ETD index at 3 mm and 10 mm behind the eyeball were significantly higher (p < 0.001) and OND/ONSD index at 3 mm behind the eyeball was significantly lower (p < 0.001) in the IIH group. The ONSD/ETD index at 3 mm had the highest area under the curve (AUC) value (0.898) with a cut-off of 0.27 mm (82% sensitivity and 91.67% specificity) for predicting high cerebrospinal fluid (CSF) pressure, followed by ONSD measurements at 3 mm (AUC = 0.886) with a cut-off of 6.17 mm (83% sensitivity and 86.67% specificity). The OND/ONSD index at 3 mm posterior to the eyeball decreased significantly as ICP increased, and the strength of the relationship was moderate (p < 0.001; r = -0.358).
CONCLUSIONS: ONSD and ONSD/ETD index measured on MRI sequences are potentially useful in detecting elevated ICP. The OND/ONSD index correlates with CSF pressure and these techniques may be helpful in diagnosing IIH.
METHODS: MRI data obtained from 50 patients with IIH and 30 age- and sex- matched controls were analyzed and optic nerve sheath diameter (ONSD), eyeball transverse diameter (ETD) and optic nerve diameter (OND) were measured. ONSD, ONSD/ETD and OND/ONSD indexes were calculated according to different ONSD measurement distances. Correlations of MRI findings with ICP were calculated. Sensitivity and specificity of all methods were analyzed.
RESULTS: ONSD and ONSD/ETD index at 3 mm and 10 mm behind the eyeball were significantly higher (p < 0.001) and OND/ONSD index at 3 mm behind the eyeball was significantly lower (p < 0.001) in the IIH group. The ONSD/ETD index at 3 mm had the highest area under the curve (AUC) value (0.898) with a cut-off of 0.27 mm (82% sensitivity and 91.67% specificity) for predicting high cerebrospinal fluid (CSF) pressure, followed by ONSD measurements at 3 mm (AUC = 0.886) with a cut-off of 6.17 mm (83% sensitivity and 86.67% specificity). The OND/ONSD index at 3 mm posterior to the eyeball decreased significantly as ICP increased, and the strength of the relationship was moderate (p < 0.001; r = -0.358).
CONCLUSIONS: ONSD and ONSD/ETD index measured on MRI sequences are potentially useful in detecting elevated ICP. The OND/ONSD index correlates with CSF pressure and these techniques may be helpful in diagnosing IIH.
摘要：
目的：诸如腰椎穿刺和心室内导管之类的侵入性方法通常用于测量颅内压（ICP）。这项研究旨在开发定量和非侵入性技术，以使用磁共振成像（MRI）结果测量特发性颅内高血压（IIH）患者的ICP。
方法：分析了50例IIH患者和30例年龄和性别匹配的对照组的MRI数据，并分析了视神经鞘直径（ONSD），测量眼球横径（ETD）和视神经直径（OND）。ONSD，根据不同的ONSD测量距离计算ONSD/ETD和OND/ONSD指数。计算MRI表现与ICP的相关性。分析了所有方法的敏感性和特异性。
结果：IIH组眼球后3mm和10mm处的ONSD和ONSD/ETD指数明显高于（p<0.001），眼球后3mm处的OND/ONSD指数明显低于（p<0.001）。3mm时的ONSD/ETD指数具有最高的曲线下面积（AUC）值（0.898），截止值为0.27mm（82％的灵敏度和91.67％的特异性），用于预测高脑脊液（CSF）压力，然后在3mm（AUC=0.886）进行ONSD测量，截止值为6.17mm（83％的灵敏度和86.67％的特异性）。眼球后方3mm的OND/ONSD指数随着ICP的增加而显著下降,关系强度中等(p<0.001;r=-0.358)。
结论：在MRI序列上测量的ONSD和ONSD/ETD指数可能有助于检测ICP升高。OND/ONSD指数与CSF压力相关，这些技术可能有助于诊断IIH。
方法：分析了50例IIH患者和30例年龄和性别匹配的对照组的MRI数据，并分析了视神经鞘直径（ONSD），测量眼球横径（ETD）和视神经直径（OND）。ONSD，根据不同的ONSD测量距离计算ONSD/ETD和OND/ONSD指数。计算MRI表现与ICP的相关性。分析了所有方法的敏感性和特异性。
结果：IIH组眼球后3mm和10mm处的ONSD和ONSD/ETD指数明显高于（p<0.001），眼球后3mm处的OND/ONSD指数明显低于（p<0.001）。3mm时的ONSD/ETD指数具有最高的曲线下面积（AUC）值（0.898），截止值为0.27mm（82％的灵敏度和91.67％的特异性），用于预测高脑脊液（CSF）压力，然后在3mm（AUC=0.886）进行ONSD测量，截止值为6.17mm（83％的灵敏度和86.67％的特异性）。眼球后方3mm的OND/ONSD指数随着ICP的增加而显著下降,关系强度中等(p<0.001;r=-0.358)。
结论：在MRI序列上测量的ONSD和ONSD/ETD指数可能有助于检测ICP升高。OND/ONSD指数与CSF压力相关，这些技术可能有助于诊断IIH。
